Clinical spectrum and diagnostic strategies non-calculous lower bile duct obstruction

O. Soreide, C. J. Kelley, A. Czerniak, N. S. Hadjis, W. H. Edwards, L. H. Blumgart

    Research output: Contribution to journalArticle

    2 Citations (Scopus)

    Abstract

    The clinical spectrum and the diagnostic strategies in 99 patients with non-calculous distal common bile duct (CBD) obstruction seen over a period of 5 years have been studied. A benign stricture was found in 26 patients. 15 had a distal cholangiocarcinoma, 11 a periampullary tumour. 45 cancer of the pancreatic head and 2 duodenal cancer. The presenting symptoms were non-specific and allowed no differentiation between the groups. Similarly, biochemical and radiological findings did not reliably distinguish benign from malignant causes of obstruction. Misdiagnosis was common except in the pancreatic tumour group, with previous surgery undertaken in 38% of the patients. A high resectability rate was found for CBD tumours (80%) and periampullary tumours (73%). High morbidity and mortality rates were found for both resective and palliative surgery. The non-specific symptom pattern in these patients and the high frequency of misdiagnosis points to the need for a thorough pre- and intra-operative diagnostic strategy. An operation should not be performed if the surgeon is not prepared to proceed with elaborate and extended surgery.

    Original languageEnglish (US)
    Pages (from-to)209-214
    Number of pages6
    JournalDigestive Surgery
    Volume2
    Issue number4
    DOIs
    StatePublished - Jan 1 1985

    Fingerprint

    Cholestasis
    Common Bile Duct
    Diagnostic Errors
    Neoplasms
    Duodenal Neoplasms
    Cholangiocarcinoma
    Head and Neck Neoplasms
    Palliative Care
    Pathologic Constriction
    Morbidity
    Mortality

    All Science Journal Classification (ASJC) codes

    • Surgery
    • Gastroenterology

    Cite this

    Soreide, O., Kelley, C. J., Czerniak, A., Hadjis, N. S., Edwards, W. H., & Blumgart, L. H. (1985). Clinical spectrum and diagnostic strategies non-calculous lower bile duct obstruction. Digestive Surgery, 2(4), 209-214. https://doi.org/10.1159/000171707

    Clinical spectrum and diagnostic strategies non-calculous lower bile duct obstruction. / Soreide, O.; Kelley, C. J.; Czerniak, A.; Hadjis, N. S.; Edwards, W. H.; Blumgart, L. H.

    In: Digestive Surgery, Vol. 2, No. 4, 01.01.1985, p. 209-214.

    Research output: Contribution to journalArticle

    Soreide, O, Kelley, CJ, Czerniak, A, Hadjis, NS, Edwards, WH & Blumgart, LH 1985, 'Clinical spectrum and diagnostic strategies non-calculous lower bile duct obstruction', Digestive Surgery, vol. 2, no. 4, pp. 209-214. https://doi.org/10.1159/000171707
    Soreide O, Kelley CJ, Czerniak A, Hadjis NS, Edwards WH, Blumgart LH. Clinical spectrum and diagnostic strategies non-calculous lower bile duct obstruction. Digestive Surgery. 1985 Jan 1;2(4):209-214. https://doi.org/10.1159/000171707
    Soreide, O. ; Kelley, C. J. ; Czerniak, A. ; Hadjis, N. S. ; Edwards, W. H. ; Blumgart, L. H. / Clinical spectrum and diagnostic strategies non-calculous lower bile duct obstruction. In: Digestive Surgery. 1985 ; Vol. 2, No. 4. pp. 209-214.
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