Etiology, Clinical Presentations, and Short-Term Treatment Outcomes of Extrahepatic Obstructive Jaundice in South-Western Uganda

Odongo, Charles Newton; Dreque, Carlos Cabrera; Mutiibwa, David; Bongomin, Felix; Oyania, Felix; Sikhondze, Mvuyo Maqhawe; Acan, Moses; Atwine, Raymond; Kirya, Fred; Situma, Martin

doi:10.2147/ceg.s356977

Cited by 2 publications

(5 citation statements)

References 27 publications

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“…In our study very few study patients had MRCP done, there is no clear reason for the low uptake of this diagnostic imaging modality, but it is speculated being because of financial constraints by many patients. This is in contrast to Lorenz et al who reported the usefulness of MRCP as a special type of diagnostic Imaging modality for hepato-biliary and pancreatic system and can distinguish between malignant and benign causes of obstructive jaundiceThe study done in Uganda and Ghana byOdongo et al, 2022 and Mercouris et al, 2023 reported very small percentages of cancer head of pancreas and choledocholithiasis, majority of the causes were gall bladder tumors. The study done in India byGulab et al, 2022, Belgium by Michael et al., 2019, Bangladesh by Roy et., al 2015 and Pakistan by Siddique et al, 2008 percentages of cancer head of pancreas and choledocholithiasis as the leading cause of obstructive jaundice among the malignant and benign causes respectively.In our study, Palliative triple bypass has been found to be a more common surgical management offered followed by laparoscopic cholecystectomy and CBD exploration by 29.7%, 14.8% and 14.8% respectively.…”

mentioning

confidence: 70%

“…The study done in Uganda and Ghana by Odongo et al, 2022 andMercouris et al, 2023 reported very small percentages of cancer head of pancreas and choledocholithiasis, majority of the causes were gall bladder tumors. The study done in India by Gulab et al, 2022, Belgium by Michael et al, 2019, Bangladesh by Roy et., al 2015and Pakistan by Siddique et al, 2008 percentages of cancer head of pancreas and choledocholithiasis as the leading cause of obstructive jaundice among the malignant and benign causes respectively.…”

Section: Discussionmentioning

confidence: 98%

“…It can be caused by many factors both intrahepatic and extrahepatic factors including; benign like cholelithiasis with cholecystitis and malignant conditions like cancer head of pancreas and cholangiocarcinoma and many others which can be identified either preoperatively using radiological diagnostic tools such as sonography, CT scan, MRCP specific for biliary tree scan or postoperatively and ERCP or Intra-operatively(Odongo et al ., 2022). Early diagnosis and treatment of patients with malignant obstructive jaundice is the speculation of the disease as resection can be done at this stage (Chalya, Kanumba and McHembe, 2011).…”

Section: Introductionmentioning

confidence: 99%

“…The most frequent surgical managements offered to obstructive jaundice patients are cholecystectomy, choledochojejunostomy, cholecystojejunostomy, and pancreatoduodenectomy (Gulab Dhar Yadav et al ., 2022; Shetty et al ., 2016). Surgeons in resource-limited settings relate the management of obstructive jaundice to difficult hurdles (Odongo et al ., 2022). When compared to non-jaundiced individuals, surgery in jaundiced patients is associated with a greater risk of postoperative complications(Gulab Dhar Yadav et al ., 2022; Shetty et al ., 2016).…”

Section: Introductionmentioning

confidence: 99%

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Clinicopathological, surgical management and early postoperative outcome among obstructive jaundice inpatients at Kilimanjaro Christian Medical Centre from March 2020 to March 2023

Chambo,

Venant,

Msuya

et al. 2023

Preprint

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Obstructive jaundice is a surgical condition that affects all age groups mostly to the above 18 individuals. This condition can lead to high morbidity and mortality if not early diagnosed and treated. It remains the common cause of surgical consultations globally accounting for 8-10/100,000 and 242/1000 annually in China and Saudi Arabia respectively. Clinicopathological and radiological investigations are the key to the disease diagnosis. Cholelithiasis and cancer head of pancreas are common causes of obstructive jaundice. Although the diagnosis and treatments of obstructive jaundice is advancing; some patients get poor treatment outcome such as SSI, peritonitis and long hospital stay with some of them dying.To determine the clinicopathological, surgical management and early postoperative outcome among obstructive jaundice inpatients at KCMC from March 2020 to March 2023.A hospital-based cross-sectional study was conducted using secondary data from hospital records, EHMS system, surgery admission and theater registry books. All files of patients aged 18 years and above from these registry books with a diagnosis of obstructive jaundice from March 2020 to March 2023 were included. The obtained data were collected using the questionnaire then entered and analyzed using SPSS version 26.A total of 101 patients were studied, with the male to female ratio of 1.2:1. Cancer head of pancreas was the commonest malignant cause of obstructive jaundice where as choledocholithiasis was the commonest benign cause. Most of the clinical presentations were abdominal pain 47.6%, yellowish discoloration of the mucous membrane, eyes and skin by 43.6% and itching by 6.9%. Both laboratory investigations and radiological imaging were done which showed elevated liver enzymes 68.3%, low Hb 46.5%, histopathology 62.4%; benign and malignant obstructive jaundice cause by 33.7% and 46.5% respectively. Among all the patients who were surgically managed 29.7% had palliative triple bypass, 14.8% had laparoscopic cholecystectomy and 14.8% had CBD Exploration. The overall complication rate was 50.5%; Death 16.5% surgical site infections 13.9% and long hospital stay 9.9%.Obstructive jaundice in our setting is more common in males where malignant causes being high in the list

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mentioning

confidence: 70%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Clinicopathological, surgical management and early postoperative outcome among obstructive jaundice inpatients at Kilimanjaro Christian Medical Centre from March 2020 to March 2023

Chambo,

Venant,

Msuya

et al. 2023

Preprint

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“…Our study appears to be consistent with other reported outcomes. For example, a study from South-Western Uganda also observed notable clinical improvements following surgical treatment for extrahepatic obstructive jaundice, with a higher number of surgical treatments performed in the benign group [29].…”

Section: Discussionmentioning

confidence: 99%

Short-term Outcomes of Surgical Treatment of Benign Obstructive Jaundice, Sana'a, Yemen.

Al-Shehari,

Obadiel,

Al-Hubaishi

et al. 2024

jchm

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Background: Obstructive jaundice is among the most challenging conditions managed by general surgeons and significantly contributes to high morbidity and mortality. Objectives: This study evaluated the short-term outcomes of surgical treatment for benign obstructive jaundice. Methods: A cross-sectional descriptive study was conducted prospectively at Al-Thawra Modern General Hospital between January 2019 and December 2021, including all patients with benign obstructive jaundice who underwent open surgical treatment. Results: The study included 36 patients with a median age of 55 years, and female predominance (63.9%) compared with male predominance (36.1%). The most common preoperative diagnosis was common bile duct stones (66.7%), followed by postcholecystectomy biliary strictures (25%). Abdominal pain (91.7%) and jaundice (83.3%) were the most frequent symptoms. Twenty-four patients with CBD stones underwent cholecystectomy with CBD exploration with either T-tube drainage (17 patients) or choledochoduodenostomy drainage (5 patients), and only two patients underwent cholecystostomy tube drainage. However, all 9 patients with postcholecystectomy biliary strictures underwent hepaticoenterostomy drainage procedures. Postoperatively, the median length of hospital stay was 6.33 (2-15) days, and direct bilirubin levels decreased in most patients by the 7th day (88.9%). Wound infection (27.8%), mild pulmonary complications (19.4%), and moderate pulmonary complications requiring ICU admission (13.9%) were the most common complications. No mortality was recorded. Conclusions: Open surgical treatment of benign obstructive jaundice is safe and effective because improved abdominal pain, subsidence of obstructive jaundice features, and postoperative bilirubin level drop were observed in almost all patients. Wound infection and pulmonary complications were the most common complications. Common bile duct stones were the leading cause of this condition, and female preponderance was observed. Future studies should focus on optimizing the management of these patients, including minimizing postoperative complications such as wound infections.

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Etiology, Clinical Presentations, and Short-Term Treatment Outcomes of Extrahepatic Obstructive Jaundice in South-Western Uganda

Cited by 2 publications

References 27 publications

Clinicopathological, surgical management and early postoperative outcome among obstructive jaundice inpatients at Kilimanjaro Christian Medical Centre from March 2020 to March 2023

Clinicopathological, surgical management and early postoperative outcome among obstructive jaundice inpatients at Kilimanjaro Christian Medical Centre from March 2020 to March 2023

Short-term Outcomes of Surgical Treatment of Benign Obstructive Jaundice, Sana'a, Yemen.

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