PALLIATIVE THERAPY OF MALIGNANT JAUNDICE - OPERATIVE BYPASS OR STENT IMPLANTATION

For therapy of malignant jaundice different methods are possible: The palliative operative bypass and the nonoperative stent implantation by endoscopic or transhepatic procedure. The primary success rate of bot h methods is similarly high (>90%). The rate of early complication and the lethality of the stent implantation compared to the operative pro cedure are lower. The rate of occlusion and incidence of later cholang itis by operative bypass are lower. Postoperative lethality is related to the ASA classification. The preoperative diagnosis of resectabilit y by CT, NMR, angiography and diagnostic laparoscopy has a success rat e of maximally 95%. The choice of therapeutic method is therefore rela ted to the general condition of the patient (ASA, staging, duodenal st enosis, expected survival time).