Management of malignant obstructive jaundice at The Middlesex Hospital

Br J Surg. 1983 Oct;70(10):584-6. doi: 10.1002/bjs.1800701006.


A total of 180 patients with malignant obstructive jaundice have been treated by 5 different methods: surgical resection; surgical by-pass; percutaneous prosthesis; endoscopic prosthesis; and endoscopic sphincterotomy (for papillary tumours). The spectrum of patients is unusual, because many elderly and ill patients were referred for nonoperative management. Operative by-pass, percutaneous and endoscopic prostheses gave similar overall results, with a mean survival of about 6 months. Patients with tumours of the papilla of Vater treated by endoscopy or surgery fared well; 11 of 18 were alive at follow-up. Median survival after resection of other tumours was 17 months. These results underline the need for randomized clinical trials, which are now in progress.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Ampulla of Vater / surgery
  • Biliary Tract Neoplasms / complications*
  • Biliary Tract Neoplasms / mortality
  • Biliary Tract Neoplasms / surgery
  • Cholestasis / etiology
  • Cholestasis / surgery*
  • Endoscopy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / complications*
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / surgery
  • Prostheses and Implants