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Cirugía paraguaya

On-line version ISSN 2307-0420


RIVAS VILLAMAYOR, Coral Alejandra; FERREIRA GAONA, Marta; PORTO VARELA, Mauro  and  MONTIEL-ROA, Arnaldo. PREOPERATIVE MANAGEMENT OF OBSTRUCTIVE JAUNDICE. Rev. Cir. Parag. [online]. 2018, vol.42, n.3, pp.18-25. ISSN 2307-0420.


Biliary obstructive jaundice is a symptom that results from cholestasis. The causes are varied, but it is commonly due to choledocholithiasis, stenosis of the bile duct, malignant biliopancreatic tumors and metastatic diseases.


To describe the preoperative management of obstructive jaundice.


Observational research, with a retrospective, descriptive study of clinical records of patients with obstructive jaundice, treated at the Central Hospital "Dr. Emilio Cubas "from January to December 2017.


81 clinical files were analyzed, mean age 60.22 ± 15.65 years (91-23), 60.49% women. On average, total bilirubin was 8.40 ± 6.90 mg / dl and direct bilirubin 5.13 ± 3.92 mg / dl, alkaline phosphatase 955.65 ± 658.61 U / L and gamma GT 270.56 ± 207 , 35 U / L. The common bile duct on average of 11.64 ± 5.76 mm by ultrasound. Accompanied by pain (97.53%), jaundice (93.83%), coluria (87.65%), acolia (53.09%) and pruritus 4.94%. Ultrasound (100%), magnetic resonance (49.38%) and simple tomography (41.98%), endoscopic cholangioretrography as diagnostic and therapeutic (83.95%), with a complication of 4.94%, were studied. Choledocholithiasis was the most frequent etiopathogenesis; 58 cases (71.60%), then the choledocholithiasis associated with other pathologies in 5 cases (5.65%). Of the most frequent causes of neoplasic jaundice was pancreatic cancer, 7 cases (8.64%). In choledocholithiasis, endoscopic cholangioretrography was performed in 49 cases (84.48%), then cholecystectomy was completed in 32 (55.17%), cholangio-surgical cholecystectomy in 9 (15.52%) cases and 1 (1.72). %) case required biliodigestive bypass. The malignant neoplasms were of palliative management, except 1 case of ampuloma.


the most frequent cause of obstructive lithiasic jaundice according to this study is choledocholithiasis, with the main condition in women. As a definitive treatment, cholangiography and / or cholecystectomy (with intraoperative cholangiography) were the standard management.

Keywords : Obstructive jaundice; choledocholithiasis; Ultrasonography; Magnetic resonance imaging; Cholangiography.

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