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Causes of Obstructive Jaundice Table I

Malignant (80-90%) Benign (10-20%) Cholangiocarcinoma Choledocolithiasis Pancreatic carcinoma Pancreatitis Gallbladder carcinoma Primary sclerosis cholangitis Hepatocellular carcinoma Iatrogenic injury Metastatic disease Cholangitis Radiation

Ischemia

Cystic disease

Cystic fibrosis

Reference:

Eleni Liapi MD Christos S Geogiades MD and Jean-Francois GeshwindMD.

Transhepatic Interventions for Obstructive Jaundice. Current Surgical

Therapy, 9th Edition; John L Cameron.

Notes:

1. The majority of patients pres.with obstructive jaundice have a malignant

obstruction of the biliary tree

2. Cholangiocarcinoma and pancreatic cancer account for most.

3. With cholangiocarcinoma, 70% will have involvement of the biliary

confluence at pres. i.e. Klatskin tumour requiring bilateral drainage.

4. A minority of patients (younger), present with obstruction secondary to

stones(frequency) iatrogenic injury.

5. This is due to more frequent use of laparoscoic biliary procedures and

obese population.

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TABLE II

Ref: Obstructive Jaundice: Endoscopic therapy Causes of Obstructive Jaundice. David

F Hutcheon, MD

Benign Neoplastic

Choledocolithiasis Pancreatic carcinoma

Benign biliary strictures* Cholangiocarcinoma

Choledocal cyst Gallbladder carcinoma

External compression:

Portal lymphadenopathy, Mirizzis synd.

pancreaticpseudocyst

Periampullary carcinoma

Islet cell carcinoma

Metastatic or adjacent neoplasms

* Postoperative, sclerosing cholangitis, papillary stenosis, chronic pancreatitis,

sphincter of Oddi dysfunction.