16. FREQUENCY OF COMMON CAUSES OF SURGICAL JAUNDICE

Qutbi Alam Jan, Muhammad Rashid Waheed, Ihtisham ul Haq, Yunas Khan

Department of Surgery, Khyber Teaching Hospital, Peshawar - Pakistan

Abstract

Objective: To determine the frequency of common causes of surgical jaundice.
Material and Methods: This study was conducted at Department of Surgery, Khyber Teaching Hospital, Peshawar,
Pakistan. Duration of the study was from February 2016 to February 2017 in which a total of 131 patients were observed.
All patients presenting to OPD with Clinical jaundice having serum Bilirubin more than 1.20 mg/dl, having Alkaline
Phosphatase levels more than 306 mg/dl, Age 15 or above and both male and female were included. The diagnosis in
all these cases was based on history, clinical examination and routine laboratory investigations including Liver Function
Tests (LFT’s).Ultrasound was undertaken in all patients to diagnose the exact cause whether choledocholithiasis or
masses obstructing the lumen of common bile duct and in cases where mass was found biopsy was taken and sent
for histopathology to detect carcinoma head of pancreas, carcinoma gall bladder, or cholangiocarinoma. All histopathology
specimens were reported by an expert histopathologist. All these patients were prepared for surgery 2 to 3
days after admission with injection vitamin K, intravenous antibiotics and infusion Mannitol, hydration status checked
and corrected. After preparation all the patients were operated on the next list.
Results: In this study mean age was 37.02 ± 13.5 SD. Out of 131 patients; there were 43.5% males and 56.5% females.
The mean serum bilirubin level was 17.88 ± 6.03.The mean serum alkaline phosphatase level was 461 ± 77.3.On
investigations; choledocholithiasis was recorded in 38.2%, ca Head of Pancreas in 24.4%, ca gallbladder in 16% and
cholangiocarcinoma in 21.4%.
Conclusion: Gallstone is a common cause of surgical jaundice in our population followed by ca head of pancreas.

Keywords: Surgical jaundice, gallstones, choledocholithiasis, ca pancreas, ca gallbladder, cholangiocarcinoma, bilirubin, alkaline phosphatase

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