Author/Editor     Trotovšek, Blaž; Tomažič, Aleš
Title     Palliative and simptomatic surgical management of patients with jaundice
Type     članek
Source     Gastroenterolog
Vol. and No.     Letnik 8, št. Suppl 2
Publication year     2004
Volume     str. 98-101
Language     eng
Abstract     A multidisciplinary approach regarding the proper technique of biliary drainage for a palliative or symptomatic treatment is important. Drainage is indicated for the relief of pruritus, cholangitis, lowering of serum bilirubin in order to permit the use of chemotherapeutic agents or brachyradiotherapy. Patients with operable disease should be treated surgically. In patients who are not candidates for surgical treatment the level of obstruction demonstrated on imaging studies should be used to triage patients to either percutaneous (PTBD) or endoscopic drainage. Surgical relief of obstructive jaundice due to malignant stricture of biliary tree is best obtained by biliary-enteric anastomosis, and Roux-en-Y hepaticojejunostomy is the favored approach with good long-term results. Bypasses to the hepatic ducts can achieve good initial decompression and relief of the symptoms. Long-term results of bypasses to bile duct for segment 3, are superior to the others in high biliary obstruction. The use of stents placed into biliary tree at the time of operative procedure, is decreasing since the introduction of PTBD and endoscopic drainage.
Descriptors     JAUNDICE
BILE DUCT NEOPLASMS
CHOLEDOCHOSTOMY
PALLIATIVE CARE
HEPATIC DUCT, COMMON
JEJUNOSTOMY
ANASTOMOSIS, ROUX-EN-Y