Relatively little attention has been given to factors affecting surgical morbidity and mortality in patients with obstructive jaundice due to malignancy. The indications for pancreaticoduodenectomy have received more attention; however, this procedure is possible in only 5% to 20% of cases.1-4 When only palliative procedures are possible the benefits of this surgery may be lost, owing to postoperative complications or death. These considerations have promoted a review of the clinical experiences with jaundice caused by malignancy. Hypotension leading to uremia has been found to be the most serious complication. Better preoperative preparation with blood volume replacement has been the only factor effective in decreasing the surgical mortality. Although the cure rate remains poor, the over-all survival has been improved through a lower operative mortality. The accuracy and dangers of biopsy, indications for gastroenterostomy at the time of surgery for inoperable lesions, and improvement in mortality rate will be discussed.
WILLIAMS RD, ELLIOTT DW, ZOLLINGER RM. Surgery for Malignant Jaundice. AMA Arch Surg. 1960;80(6):992-997. doi:10.1001/archsurg.1960.01290230110014