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Invasive, Diagnostic, and Therapeutic Procedures With Too High a Price?

Kenneth R. Sirinek, MD, PhD; Barry A. Levine, MD

Arch Surg. 1989;124(8):885-888.

Abstract
• To investigate and/or treat the causes of jaundice, 221 patients underwent the following procedures over 7 years: percutaneous transhepatic cholangiography (PTC) alone (104 patients), PTC with external biliary drainage (69 patients), or PTC with external/internal biliary drainage (48 patients). Forty-nine procedure-related complications occurred in 39 patients (18%). Three patients (1.5%) required an emergency operation for hepatic hemorrhage (2 patients) and a perforated gallbladder (1 patient). Two patients (1%) died as a direct result of the procedure secondary to hemorrhage (1 patient) and sepsis (1 patient). Preoperative biliary decompression, although technically (95%) and physiologically (82%) successful in the majority of patients, had no therapeutic benefit when compared (nonrandomized) with those patients without alleviation of jaundice prior to surgical intervention.

(Arch Surg. 1989;124:885-888)

Author Affiliations
From the Department of Surgery, the University of Texas Health Science Center, San Antonio.

Footnotes
Accepted for publication April 19, 1989.

Read before the 96th Annual Meeting of the Western Surgical Association, San Diego, Calif, November 14, 1988.

Reprint requests to the Department of Surgery, University of Texas Health Science Center, 7703 Floyd Curl Dr, San Antonio, TX 78284-7842 (Dr Sirinek).

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