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Type: Journal article
Title: The effect of communication between the right and left liver on the outcome of surgical drainage for jaundice due to malignant obstruction at the hilus of the liver
Author: Baer, H.
Rhyner, M.
Stain, S.
Dennison, A.
Maddern, G.
Blumgart, L.
Citation: HPB Surgery, 1994; 8(1):27-31
Publisher: Harwood Academic Publishers
Issue Date: 1994
ISSN: 0894-8569
Statement of
H. U. Baer, M. Rhyner, S. C. Stain, P. W. Glauser, A. R. Dennison, G. J. Maddern, and L. H. Blumgart
Abstract: Debate continues regarding the optimal management of irresectable malignant proximal biliary obstruction. Controversy exists concerning the ability of unilateral drainage to provide adequate biliary decompression with tumors that have occluded the communication between the right and left hepatic ductal systems. Between October 1986 and October 1989, 18 patients with malignant proximal biliary obstruction were treated by an intrahepatic biliary enteric bypass. Patients were divided into two groups based on the presence or absence of a communication between the right and left biliary systems. In Group I (n = 9), there was free communication; and in Group II (n = 9) there was no communication. There were two perioperative deaths (11%) one due to persistent cholangitis and the other to myocardial insufficiency both with one death in each group. The median survival (excluding perioperative deaths) was 5.6 months. Comparison of pre- and postoperative serum levels of bilirubin and alkaline phosphatase showed a significant decrease in each group, but no difference between the groups in the size of the reduction. Sixteen patients survived at least three months and the palliation was judged as excellent in eight, fair in five, and unchanged in three. These results demonstrate the effectiveness of biliary enteric bypass regardless of communication between the left and right biliary ductal systems.
Keywords: Bile Ducts, Intrahepatic
Bile Duct Neoplasms
Gallbladder Neoplasms
Liver Neoplasms
Pancreatic Neoplasms
Cholestasis, Intrahepatic
Constriction, Pathologic
Postoperative Complications
Alkaline Phosphatase
Postoperative Care
Preoperative Care
Anastomosis, Surgical
Survival Rate
Case-Control Studies
Retrospective Studies
Middle Aged
Rights: Copyright © 1994 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: 10.1155/1994/17262
Published version:
Appears in Collections:Aurora harvest 7
Surgery publications

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