The morbidity and mortality associated with surgical procedures on the biliary tract are quite low, except in the presence of jaundice. A study of 350 patients with surgical jaundice from all causes suggested that hypotension followed by uremia was a common complication which warranted further investigation. This suspicion was confirmed by a series of animal experiments. A plan of management of the jaundiced patient, based on clinical and experimental studies, will be presented.
From January, 1947, through December, 1959, surgery was performed for the relief of jaundice in 350 patients at the University Hospital. The causes of jaundice are shown in Figure 1. Two important aspects of surgical jaundice were noted from this group of patients. These concerned a need for a more accurate preoperative diagnosis and a lower surgical mortality.The importance of diagnostic accuracy in the management of jaundiced patients has been previously stressed.1 Through
WILLIAMS RD, ELLIOTT DW, ZOLLINGER RM. The Effect of Hypotension in Obstructive Jaundice. Arch Surg. 1960;81(2):334–340. doi:10.1001/archsurg.1960.01300020162022
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