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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.