[Dose standardized management of patients with occlusive jaundice reduce morbidity and mortality?].

Patients with obstructive jaundice have a high incidence of complications. Invasive techniques required for definitive diagnosis and treatment compound the situation. In a prospective randomised trial we studied 54 patients over a 12-month period. All had obstructive jaundice (bilirubin greater than 100 mg/%). Prior to treatment, the trial protocol required correction of fluid balance (CVP), administration of albumin and vitamin K and an adequate urine output. Antibiotics were administered in accordance with a strict regime. The overall mortality was 7.5%, in elective cases with a mortality of 4%, in emergency cases with a mortality of 100%. The surgical treated patients had a higher incidence of complications than patients with interventional procedure, but not a higher mortality. Patients with obstructive jaundice will benefit from an adequate pre-treatment resuscitation and a standardised treatment policy after elimination of the obstruction.