[Assessment of severity of obstructive jaundice of tumoral genesis for predicting of endoscopic retrograde cholangiopancreatography and endoscopic retrograde biliary decompression complications].
Mechanical jaundice is a vital indication for performing biliary decompression. Mechanical jaundice is one of the important reasons of serious and frequent complications after ERCP. It is required to assess patient's conditions, to determinate the potential risk of biliary decompretion with the aim of prognosis possible complications. AIM OF THE INVESTIGATION: Assessment of severity patient's conditions to prognosticate risk of complications and mortality development after ERCP in the group of patients who suffered from mechanical jaundice. TASKS: Preoperative analysis of complications severity and frequency after ERCP in dependence of patients'conditions.


METHODS
Before performing ERCP severity of mechanical jaundice was assessed concerning V.D. Fedorov's scale (2000); cholangitis was detected by blood analysis, symptoms and bile investigations; coagulative disorders were revealed by blood checking. Effectiveness and complication's possibilities were controlled after each ERCP. Relations between ERCP and complications, severity of complications and patient's conditions were analyzed.


METHODS
Prospective nonrandomized study was held, based on the investigation and treatment of 133 patients who have been performed 214 diagnostic and therapeutic ERCP.


RESULTS
There were 13 (9.8%) complications of 133, of which fatal--6 (4.5%) and there were 7 cases (6.5%) in a jaundice group. In 11 cases (85%) mechanical jaundice was severe, including 6 fatal cases (100%). Cholangitis was diagnosed in 7 (53%) of 13, including 4 (67%) of 6 in the fatal group. Coagulopathy was diagnosed in 6 (46%) of 13, including 3 (50%) in the fatal group.


CONCLUSIONS
Preoperative assessment of severity patient's condition is a very important element of clinical patient's study. It optimizes the choice of method and its particularities. It is necessary to inform the doctors, the patients or their representatives about possible complications. That is why the informed consent must be obligatory signed.
Burdiukov
M S
MS
Nechipaĭ
A M
AM
Iurichev
I N
IN
D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects* / Q000379:methods; D019299:Decompression, Surgical / Q000009:adverse effects* / Q000379:methods; D004067:Digestive System Neoplasms / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D041781:Jaundice, Obstructive / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome