Objective:To study the prevention and management of early post-cholecystectomy jaundice.
Methods :The dinical data of 43 cases of jaundice occurring within one week after simple open cholecystectomy in 11 226 cases were retrospectively analyzed.
Results:The incidence of jaundice at one week after operation was 0.38% in simple open cholecystectomy, among them, medical jaundice accounted for 18 cases, and surgical jaundice for 25cases. Ultrasound,ERCP,MRCP,liver enzyme profile and reoperation confirmed the folowing: Extra-hepatic bile duct or the right hepatic duct was ligated in 9 cases,common bile duct residual stone in 6,partial gallbladder or gallbladder duct stone in 4,biliary leak in 4, cholangitic hepatitis in 4,hepatitis B or posthepatitis cirrhosis in 5,icterus after blood transfusion in 2,hemobilia in 2, ligation of right branch of hepatic artery in 2, and icterus of unknown causes in 5 cases. Reoperation was done in 8 cases, with one mortality.
Conclusions:Detailed case history,adequate examination before operation,and careful operative technique are the essential prerequisites to prevent early post-cholecystectomy jaundice. Early post-cholecystectomy jaundice should be treated according to the different causes.