ภาวะทางเดินน้ำดีอุดตันที่มิได้เกิดจากนิ่วไม่ทราบสาเหตุในโรงพยาบาลมะการักษ์

บทคัดย่อ

          Six cases of obstructive jaundice with periarnpullary carcinoma were reviewed from 1997 to 1992. The advanced and non operative cases were excluded. Only 6 resectable cases were found in the first admission. The biopsy and bypass procedures were done in 3 cases. All of them died in 3 months after the pathological reports showed adenocarcinoma. The biopsy was done in another one and then Whipple operation a month after. The patient died 1 year later with spreading tumor. The Whipple operation were done in the other 2 without biopsy. The result was good after 3 months follow up in the first one and the other was healthy until now, 1 years and 9 months later.

          Obstructive jaundice without stone always be malignant lesions and the investigations can be concluded in most cases. Decision making during exploration is difficult. This report shows better result in aggressive approach but the amount of patient is too small. However we suggest aggressive approch in obstructive jaundice without stone.