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

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dc.contributor.authorBaer, H.
dc.contributor.authorRhyner, M.
dc.contributor.authorStain, S.
dc.contributor.authorDennison, A.
dc.contributor.authorMaddern, G.
dc.contributor.authorBlumgart, L.
dc.date.issued1994
dc.description.abstractDebate 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.
dc.description.statementofresponsibilityH. U. Baer, M. Rhyner, S. C. Stain, P. W. Glauser, A. R. Dennison, G. J. Maddern, and L. H. Blumgart
dc.identifier.citationHPB Surgery, 1994; 8(1):27-31
dc.identifier.doi10.1155/1994/17262
dc.identifier.issn0894-8569
dc.identifier.issn1607-8462
dc.identifier.orcidMaddern, G. [0000-0003-2064-181X]
dc.identifier.urihttp://hdl.handle.net/2440/10402
dc.language.isoen
dc.publisherHarwood Academic Publishers
dc.rightsCopyright © 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.
dc.source.urihttps://doi.org/10.1155/1994/17262
dc.subjectBile Ducts, Intrahepatic
dc.subjectHumans
dc.subjectCholangiocarcinoma
dc.subjectBile Duct Neoplasms
dc.subjectGallbladder Neoplasms
dc.subjectLiver Neoplasms
dc.subjectPancreatic Neoplasms
dc.subjectCholestasis, Intrahepatic
dc.subjectConstriction, Pathologic
dc.subjectPostoperative Complications
dc.subjectBilirubin
dc.subjectAlkaline Phosphatase
dc.subjectDrainage
dc.subjectPostoperative Care
dc.subjectPreoperative Care
dc.subjectAnastomosis, Surgical
dc.subjectSurvival Rate
dc.subjectCase-Control Studies
dc.subjectRetrospective Studies
dc.subjectAdult
dc.subjectAged
dc.subjectMiddle Aged
dc.subjectFemale
dc.subjectMale
dc.titleThe 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
dc.typeJournal article
pubs.publication-statusPublished

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