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- Scopus: eid_2-s2.0-0026458706
- PMID: 1440241
- WOS: WOS:A1992JX03800009
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Article: Surgery for malignant obstructive jaundice: Analysis of mortality
Title | Surgery for malignant obstructive jaundice: Analysis of mortality |
---|---|
Authors | |
Issue Date | 1992 |
Publisher | Mosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/surg |
Citation | Surgery, 1992, v. 112 n. 5, p. 891-896 How to Cite? |
Abstract | Surgery on patients with malignant obstructive jaundice carries formidable morbidity and mortality rates. Clinical records of 120 consecutive patients who had a serum total bilirubin levels of 100 μmol/L or greater before exploration were analyzed retrospectively to provide guidelines for better management. Although most patients underwent bilienteric bypass to either the extrahepatic (n = 45) or intrahepatic ductal system (n = 28), resection was possible in 32 (26.7%). Complications developed in 42 patients (35%), among whom 12 (10%) required reexploration and 32 (26.7%) died within the same hospitalization. Identification of risk factors associated with hospital deaths after surgery was conducted on 84 of the 120 (group A) patients randomly selected from the entire study period. Based on multivariate analysis, age greater than 65 years, a raised serum aspartate transaminase value greater than 90 IU, and serum urea level greater than 7 mmol/L before surgery were the risk factors selected from 39 different clinical (n = 6), laboratory (n = 26), and operative (n = 7) parameters studied. The predictive value was validated in the remaining 36 patients (group B), and a high-risk patient population had been isolated. Because both serum urea and aspartate transaminase values correlated significantly with the necessity of urgent exploration, aggressive nonoperative treatment should be used to control the emergency. Alternative therapeutic options or perioperative management should be considered for the selected high-risk patients before definitive surgical biliary decompression. |
Persistent Identifier | http://hdl.handle.net/10722/172663 |
ISSN | 2023 Impact Factor: 3.2 2023 SCImago Journal Rankings: 1.096 |
ISI Accession Number ID |
DC Field | Value | Language |
---|---|---|
dc.contributor.author | Lai, ECS | en_HK |
dc.contributor.author | Chu, KM | en_HK |
dc.contributor.author | Lo, CY | en_HK |
dc.contributor.author | Mok, FPT | en_HK |
dc.contributor.author | Fan, ST | en_HK |
dc.contributor.author | Lo, CM | en_HK |
dc.contributor.author | Wong, J | en_HK |
dc.date.accessioned | 2012-10-30T06:24:07Z | - |
dc.date.available | 2012-10-30T06:24:07Z | - |
dc.date.issued | 1992 | en_HK |
dc.identifier.citation | Surgery, 1992, v. 112 n. 5, p. 891-896 | en_HK |
dc.identifier.issn | 0039-6060 | en_HK |
dc.identifier.uri | http://hdl.handle.net/10722/172663 | - |
dc.description.abstract | Surgery on patients with malignant obstructive jaundice carries formidable morbidity and mortality rates. Clinical records of 120 consecutive patients who had a serum total bilirubin levels of 100 μmol/L or greater before exploration were analyzed retrospectively to provide guidelines for better management. Although most patients underwent bilienteric bypass to either the extrahepatic (n = 45) or intrahepatic ductal system (n = 28), resection was possible in 32 (26.7%). Complications developed in 42 patients (35%), among whom 12 (10%) required reexploration and 32 (26.7%) died within the same hospitalization. Identification of risk factors associated with hospital deaths after surgery was conducted on 84 of the 120 (group A) patients randomly selected from the entire study period. Based on multivariate analysis, age greater than 65 years, a raised serum aspartate transaminase value greater than 90 IU, and serum urea level greater than 7 mmol/L before surgery were the risk factors selected from 39 different clinical (n = 6), laboratory (n = 26), and operative (n = 7) parameters studied. The predictive value was validated in the remaining 36 patients (group B), and a high-risk patient population had been isolated. Because both serum urea and aspartate transaminase values correlated significantly with the necessity of urgent exploration, aggressive nonoperative treatment should be used to control the emergency. Alternative therapeutic options or perioperative management should be considered for the selected high-risk patients before definitive surgical biliary decompression. | en_HK |
dc.language | eng | en_US |
dc.publisher | Mosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/surg | en_HK |
dc.relation.ispartof | Surgery | en_HK |
dc.subject.mesh | Adult | en_US |
dc.subject.mesh | Aged | en_US |
dc.subject.mesh | Aged, 80 And Over | en_US |
dc.subject.mesh | Cholestasis - Mortality - Surgery - Therapy | en_US |
dc.subject.mesh | Drainage | en_US |
dc.subject.mesh | Female | en_US |
dc.subject.mesh | Humans | en_US |
dc.subject.mesh | Male | en_US |
dc.subject.mesh | Middle Aged | en_US |
dc.subject.mesh | Postoperative Complications - Epidemiology - Mortality | en_US |
dc.subject.mesh | Preoperative Care | en_US |
dc.subject.mesh | Retrospective Studies | en_US |
dc.subject.mesh | Risk Factors | en_US |
dc.title | Surgery for malignant obstructive jaundice: Analysis of mortality | en_HK |
dc.type | Article | en_HK |
dc.identifier.email | Chu, KM: chukm@hkucc.hku.hk | en_HK |
dc.identifier.email | Fan, ST: stfan@hku.hk | en_HK |
dc.identifier.email | Lo, CM: chungmlo@hkucc.hku.hk | en_HK |
dc.identifier.email | Wong, J: jwong@hkucc.hku.hk | en_HK |
dc.identifier.authority | Chu, KM=rp00435 | en_HK |
dc.identifier.authority | Fan, ST=rp00355 | en_HK |
dc.identifier.authority | Lo, CM=rp00412 | en_HK |
dc.identifier.authority | Wong, J=rp00322 | en_HK |
dc.description.nature | link_to_subscribed_fulltext | en_US |
dc.identifier.pmid | 1440241 | - |
dc.identifier.scopus | eid_2-s2.0-0026458706 | en_HK |
dc.identifier.volume | 112 | en_HK |
dc.identifier.issue | 5 | en_HK |
dc.identifier.spage | 891 | en_HK |
dc.identifier.epage | 896 | en_HK |
dc.identifier.isi | WOS:A1992JX03800009 | - |
dc.publisher.place | United States | en_HK |
dc.identifier.scopusauthorid | Lai, ECS=36932159600 | en_HK |
dc.identifier.scopusauthorid | Chu, KM=7402453538 | en_HK |
dc.identifier.scopusauthorid | Lo, CY=16417392800 | en_HK |
dc.identifier.scopusauthorid | Mok, FPT=6603786245 | en_HK |
dc.identifier.scopusauthorid | Fan, ST=7402678224 | en_HK |
dc.identifier.scopusauthorid | Lo, CM=7401771672 | en_HK |
dc.identifier.scopusauthorid | Wong, J=8049324500 | en_HK |
dc.identifier.issnl | 0039-6060 | - |