Analysis The Influence Of Serious Obstructive Jaundice On Major Operation Complication

Objective To investigate the influence of serious obstructive jaundice on major operation complication.And to explore the method of intensifying the serious obstructive jaundice perioperative management .Methods The clinical data of 195 cases with Obstructive jaundice underwent operation in our department form September 2002 to March 2007 were reviewed. Among those 83 cases were underwent the open-abdomen major operation.These patients are divided into two groups according to clinical manifestation with the level of total bilirubin(TBIL):group A,the patients who have jaundice with TBIL<171μmol/L;group B, the patients who have jaundice with TBIL> 171μmol/ L.The general conditions and clinical results were compared between the two groups.The data were analysised with SPSS software.Result The average volume of hemorrhage during operation in group B(1280.6士904.4m1) is higher than in groupA(801.9士602.4m1).The difference is statistically significant((t=15.684, P<0.05). The rate of hemorrhage complication after operation in group B is higher than in groupA(x2=4.298, P<0.05).The rate of infection complication in groupB is higher than in groupA(x2=9.711, P<0.01)。The rate of acute renal failure (ARF) after operation in group B is higher than in groupA.The differences are statistically significant(x2=5.661,P<0.05)。(x2=4.332,P<0.05);The rate of reoperation in groupB is higher than in groupA.The differences are statistically significant(x2=4.332,P<0.05).And The death rate in groupB is also higher than in groupA.The differences are statistically significant(x2=4.326 , P<0.05).Conclusion Obstructive jaundice is one of the major risk factors of operation. Among the preoperative patients with TBIL >171μmol/L,particularly with TBIL>342μmol/L,the average volume of hemorrhage during operation and The rates of postoperative complications,reoperation and death are all increased obviously. Enforcing the perioperative treatment should be done to reduce the rates of complications and death.