Abstract
During the five year period between Jan., 1968 and March, 1974, 37 patients with obstructive jaundice were operated upon at the Okura National Hospital.
As the cause of jaundice 20 (54%) patients was benign and 17 (46%) patients had malignant lesion.
Common duct stone was a most common cause of benign obstructive jaundice and numbered 19 (95%). In malignant lesion, cancer of the head of pancreas was a most common cause and numbered 12 (70%).
In benign lesion, 9 patients underwent choledocho-duodenostomy, 5 patients transduodenal-sphincteroplasty, 5 patients choledochostomy and 1 patient other procedure.
In malignant lesion, 4 (23.5%) patients treated by resection and remaining 13 patients had an intestinal biliary by-pass procedure in which 4 patients treated with cholecysto-enterostomy, 4 patients with choledocho-enterostomy, 2 patients with Longmire's operation and 3 patients with other procedure.
The overall operative mortality was 24.3%, and in benign lesion 1 (5%) patient died and in malignant lesion 8 (47%) patients died postoperatively.
The striking finding is the high mortality (75%) after cholecysto-enterostomy.
A comparative study of choledocho-duodenostomy and transduodenal spbincteroplaty was carried out.
Choledocho-intestinal anastomosis is the preferred operation for palliative biliary-intestinal decom-pression because the high mortality rate was resulted if cholecysto-intestinal anastomosis was performed.
