A retrospective analysis of etiological spectrum, clinical presentation, treatment and outcome of extra hepatic biliary tree obstruction at a tertiary teaching hospital in Addis Ababa, Ethiopia
Background: Extrahepatic biliary tree obstruction (EHBO) is a common problem in surgical gastroenterological practice. The condition can be caused by the obstruction of the bile duct with gall stones, strictures and hepato-biliary malignancy.
Objective: - assess the etiological spectrum, clinical presentation, treatment and outcome of patients with EHBO who were admitted and operated at St. Paul Hospital Millennium Medical College (SPHMMC) surgical department from January 1st 2012- December 30 2015 G.C
Methodology: A retrospectives analysis of all patients admitted and operated at SPHMMC with a diagnosis of EHBO in the three years period was done. Operation theater log book was used to identify patients’ medical records. Data was collected using a pretested structured data collection format and analyzed with SPSS version 20.
Results: Totally 116 patients, 62 (53.4%) females, were operated for EHBO. Age of patients ranged from 21-80 with a mean of 40.3years. Abdominal pain 107(92.2%) and jaundice 98(84.5%) were the two most common presenting complaint. Abdominal U/S was the main imaging modality and diagnosed the etiology in of 88.8% of the patients. Benign conditions were the most common causes of EHBO 79 (68.1%), CBD stone being the main diagnosis 70(60.3%). Pancreatic head tumor (PHT) was the commonest cause of malignant EHBO19(51.3%) followed by cholangiocarcinoma 15(40.5%). The commonest operations were cholidochoduodenostomy, 50(43.1%) and cholecystojejunostomy with Braun’s anastomosis 22(19%).
Conclusion: Abdominal pain and jaundice were the main presenting symptoms of EHBO which was mainly caused by CBD stone and PHT. The main surgeries were bypass operation
Key word: CBD, Stone, Jaundice
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