Armstrong C P, Dixon J M, Taylor T V, Davies G C
Br J Surg. 1984 Mar;71(3):234-8. doi: 10.1002/bjs.1800710326.
One hundred and twenty consecutive deeply jaundiced patients undergoing surgery for bile duct obstruction were analysed. Diagnosis by either ultrasound or percutaneous transhepatic cholangiography was correct in 84 per cent and 86 per cent of patients respectively. Combination of the two procedures resulted in a diagnostic accuracy of 96.5 per cent. Despite pre-operative antibiotics and intravenous fluids, including Mannitol, infective complications and renal failure were common. Gastrointestinal haemorrhage was a major cause of postoperative morbidity and mortality. The operative mortality in this series was 14.2 per cent and was related to the depth of jaundice in patients with benign disease. The same relationship did not appear to occur in those with malignant disease. The median survival after palliative bypass surgery in patients with malignant obstruction was 6.5 months.
对120例因胆管梗阻接受手术的连续性深度黄疸患者进行了分析。超声或经皮经肝胆管造影的诊断分别在84%和86%的患者中正确。两种检查方法联合使用使诊断准确率达到96.5%。尽管术前使用了抗生素和静脉输液，包括甘露醇，但感染性并发症和肾衰竭仍很常见。胃肠道出血是术后发病和死亡的主要原因。该系列手术死亡率为14.2%，与良性疾病患者的黄疸深度有关。恶性疾病患者似乎不存在这种关系。恶性梗阻患者姑息性搭桥手术后的中位生存期为6.5个月。
