Role of Intervention in Alleviating Symptoms of Patients with Obstructive Jaundice of Malignant Pathology; A Retrospective Study in Tertiary Care Hospital of Lahore
AbstractObjective: to assess the role of intervention and MDT in alleviating symptoms of patients with jaundice of malignant obstructive pathology so the ratio of mortality and morbidity can be reduced.
Methods: It is a retrospective study consisting of 62 patients having obstructive jaundice due to malignant pathology who were presented during January 2015 to January 2023 were studied. Patients were investigated, diagnosed and staged. Their operability and resectibility were assessed according to NCCN guidelines.
Results : Among 62 patients 61% were females while 39% males. Most effected age group was 40-53 years. Mostly obstructive jaundice was reported due to Carcinoma of head of pancreas 56% and second most common pathology was periampullary. Interventions done to relieve symptoms include Whipple procedure (52%), double bypass (23%), ERCP/PTBD (8%), and DP with splenectomy (3%). The outcome of these interventions shows 58% of patients were alive while 24% of pathology recurred.
Conclusion : Whipples' procedure has encouraging results in decreasing the death rate among patients with malignant obstructive jaundice. TThe most common cause of malignant obstructive jaundice is the carcinoma of the head of the pancreas which is more prevalent in the female population. Palliative surgery is the only treatment modality available for many patients as this disease presents in advanced stages. This study suggests that early diagnosis and treatment play an important role in the prognosis of patients with obstructive jaundice with less recurrence in patients that were tumor free. This study highlights and emphasizes the importance of MDT as interdepartmental delay and long investigation time contribute to high mortality
Keywords:Intervention, Obstructive jaundice, Whipples' procedure, Malignant pathology
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