Title: Evaluation of Liver Function and Symptomatic Relief after PTBD in Patients with Malignant Obstructive Jaundice
Authors: Kumar Jitendra, Jalaj Anjani, Ojha Amit, Yadav Pankaj
Background: Obstructive jaundice is a surgical problem that occurs when there is an obstruction to the passage of conjugated bilirubin from liver cells to intestine. It is a challenging condition managed by general surgeons and contributes significantly to high morbidity and mortality. The management of obstructive jaundice poses diagnostic and therapeutic challenges to general surgeons practicing specially in resource limited area.
Aims and Objectives: To investigate the clinical outcome of percutaneous transhepatic biliary drainage in patients with malignant obstructive jaundice
To assess the effect on quality of life (QOL) and liver function in patients with malignant obstructive jaundice who have undergone PTBD.
Methods: From 2017 to 2018, 50 patients of malignant obstructive jaundice were taken and PTBD procedure was performed under USG and fluoroscopic guidance, using digital subtraction angiography machine at Department of Surgery, G.R. Medical College &J.A. Group of Hospitals, Gwalior. Results were collected and statistical analysis was done to reach the final conclusion.
Results: Majority of the patients were females (68%). Age of study cohort ranged from 36 to80 years. Majority of the patients had jaundice (100%) as the most common symptom followed by pain in abdomen (82%), Itching/ pruritus (52%), Weakness (36%), Anorexia/decreased appetite (40%) and Yellowish discoloration of eye and urine (28%). In our study PTBD was performed and we found that it was successful in first attempt in 90% of the patients. Percutaneous biliary stenting provided significantly better drainage with symptomatic relief of the symptoms and lower complication.
Conclusions: PTBD is an effective method of biliary tract decompression and it is animportant alternative to endoscopic drainage. Percutaneous drainage of biliary ducts decompresses mechanical jaundice and decreases typical serum markers of cholestasis. PTBD is indicated in patients with inoperable biliary tract malignancy with obstructive jaundice as a preferred palliative procedure.
Keywords: Malignant obstructive jaundice, carcinoma gall bladder, cholangiocarcinoma.