Prospective And Retrospective Clinical Study And Management Of Obstructive Jaundice

Background: Obstructive jaundice (OJ) is a clinical condition caused by blockage of bile flow, resulting in conjugated hyperbilirubinemia. It may arise from benign causes such as choledocholithiasis and strictures, or malignant causes including pancreatic, gallbladder, and periampullary carcinomas.

Objective: To evaluate the clinical profile, laboratory findings, imaging features, management strategies, and postoperative outcomes in patients with obstructive jaundice.

Methods: This prospective and retrospective observational study included 40 patients with obstructive jaundice admitted to the Department of General and Oncology Surgery, P.B.M. Hospital, Bikaner, between July 2009 and December 2011. Clinical features, laboratory parameters, imaging findings (USG, MRCP, CT), operative procedures, and postoperative complications were recorded and analyzed. Statistical significance was assessed using Chi-square, Fisher’s exact, and Student’s t-tests (p < 0.05).

Results: The peak incidence of OJ was between 31–70 years, with a female predominance (67.5%). Pain (82.5%) and jaundice (62.5%) were the most common presenting symptoms. Benign causes accounted for 62.5% of cases, predominantly choledocholithiasis (47.5%), while malignancy accounted for 37.5%, mainly pancreatic and periampullary carcinomas. Laboratory findings showed significantly higher bilirubin, alkaline phosphatase, and prothrombin time in malignant cases, with lower serum albumin. USG accurately detected CBD calculi and choledochal cysts in most cases. Surgical interventions were the mainstay for benign causes, whereas curative and palliative procedures were employed for malignant cases. Postoperative complications occurred in 27.5% of patients.

Conclusion: Clinical evaluation, biochemical markers, and imaging play vital roles in differentiating benign from malignant obstructive jaundice. Early diagnosis and individualized management are essential to optimize outcomes and minimize postoperative complications