Jaundice surgery
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]
Overview
Surgery is not the first-line treatment option for patients with jaundice. Surgery is usually reserved for patients with either cirrhosis, cholestasis, and liver failure. The surgical procedures which are used to treat jaundice include transjugular intrahepatic portosystemic shunting (TIPS), cholecystectomy, and liver transplantation.
Surgery
Surgery is not the first-line treatment option for patients with jaundice. Surgery is usually reserved for patients with either:
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Transjugular intrahepatic portosystemic shunting
- Transjugular intrahepatic portosystemic shunting (TIPS) is bypassing the high flow rate of portal vein into the systemic veins.
- TIPS would decrease the pressure over the portal system and a decreases risk of complications, such as:[1]
Cholecystectomy
- Cholecystectomy is usually done through laparoscopic route, to treat cholestasis.
- During cholecystectomy, gallbladder along with contained stones are excised.
- The reason of cholestasis include:[2]
- Cholecystectomy is indicated in patients with:[3]
- Cholecystitis (Acute/Chronic)
- Symptomatic cholelithiasis
- Biliary dyskinesia
- Acalculous cholecystitis
- Gallstone pancreatitis
- Gallbladder masses/polyps
- Cholecystectomy contraindications include:[3]
- Inability to tolerate pneumoperitoneum or general anesthesia
- Uncorrectable coagulopathy
- Metastatic disease
Liver transplantation
- Liver transplantation is indicated in case of liver failure.
- Liver failure may be due to any diseases including cirrhosis or chronic portal hypertension.[4]
References
- ↑ Lahat E, Lim C, Bhangui P, Fuentes L, Osseis M, Moussallem T, Salloum C, Azoulay D (2017). "Transjugular intrahepatic portosystemic shunt as a bridge to non-hepatic surgery in cirrhotic patients with severe portal hypertension: a systematic review". HPB (Oxford). doi:10.1016/j.hpb.2017.09.006. PMID 29110990.
- ↑ Nagral S (2005). "Anatomy relevant to cholecystectomy". J Minim Access Surg. 1 (2): 53–8. doi:10.4103/0972-9941.16527. PMC 3004105. PMID 21206646.
- ↑ 3.0 3.1 "Gallbladder, Cholecystectomy, Laparoscopic - StatPearls - NCBI Bookshelf".
- ↑ Starzl TE, Van Thiel D, Tzakis AG, Iwatsuki S, Todo S, Marsh JW; et al. (1988). "Orthotopic liver transplantation for alcoholic cirrhosis". JAMA. 260 (17): 2542–4. PMC 3091380. PMID 3050180.