Search tips
Search criteria 


Logo of jrsocmedLink to Publisher's site
J R Soc Med. 1985 March; 78(3): 211–216.
PMCID: PMC1289636

Surgical relief of obstructive jaundice in a district general hospital.


Fifty consecutive patients with obstructive jaundice treated by operation in Canterbury & Thanet Health District hospitals under the care of one surgeon (RECC) over a 6-year period have been studied. The pathology was found to be common bile duct (CBD) stone in 22 patients (44%); pancreatic carcinoma in 15 (30%), 3 of whom also had CBD stones; chronic pancreatitis in 4 (8%); extrahepatic CBD carcinoma in 4 (8%); ampulla of Vater carcinoma in 3 (6%); primary duodenal carcinoma in 1 (2%); and portahepatis obstruction in 4 (8%). The 8 postoperative deaths (16%) were found to be associated with high preoperative levels of serum bilirubin, but all occurred in patients with malignant disease. Complications occurred in 20 patients (40%) and bile culture state was found to be intimately related to the morbidity rather than operative mortality. The study represents a careful audit of the pathology distribution and the surgical management of obstructive jaundice as seen in district hospitals.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (677K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Allison ME, Prentice CR, Kennedy AC, Blumgart LH. Renal function and other factors in obstructive jaundice. Br J Surg. 1979 Jun;66(6):392–397. [PubMed]
  • Bailey ME. Endotoxin, bile salts and renal function in obstructive jaundice. Br J Surg. 1976 Oct;63(10):774–778. [PubMed]
  • Boey JH, Way LW. Acute cholangitis. Ann Surg. 1980 Mar;191(3):264–270. [PubMed]
  • Cotton PB. Non-operative removal of bile duct stones by duodenoscopic sphincterotomy. Br J Surg. 1980 Jan;67(1):1–5. [PubMed]
  • Dawson JL. Renal failure in obstructive jaundice--clinical aspects. Postgrad Med J. 1975 Aug;51(598):510–511. [PMC free article] [PubMed]
  • Herter FP, Cooperman AM, Ahlborn TN, Antinori C. Surgical experience with pancreatic and periampullary cancer. Ann Surg. 1982 Mar;195(3):274–281. [PubMed]
  • Irving JD. Relief of biliary obstruction. Br J Hosp Med. 1981 Oct;26(4):329–338. [PubMed]
  • Safrany L. Endoscopic treatment of biliary-tract diseases. An international study. Lancet. 1978 Nov 4;2(8097):983–985. [PubMed]
  • Shapiro TM. Adenocarcinoma of the pancreas: a statistical analysis of biliary bypass vs Whipple resection in good risk patients. Ann Surg. 1975 Dec;182(6):715–721. [PubMed]
  • Steiger E, Seltzer MH, Rosato FE. Cholecystectomy in the aged. Ann Surg. 1971 Jul;174(1):142–144. [PubMed]
  • Vellacott KD, Powell PH. Exploration of the common bile duct: a comparative study. Br J Surg. 1979 Jun;66(6):389–391. [PubMed]
  • Wenckert A, Robertson B. The natural course of gallstone disease: eleven-year review of 781 nonoperated cases. Gastroenterology. 1966 Mar;50(3):376–381. [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press