BACKGROUND/AIMS: Although malignant obstruction, itself, is a significant r
isk factor associated with post-operative mortality, factors affecting mort
ality in the surgery of malignant obstruction have not been thoroughly stud
ied in the literature.
METHODOLOGY: In order to identify independent risk factors which might be a
ssociated with an increase in post-operative mortality in patients with mal
ignant biliary obstruction, 24 clinical and laboratory parameters in 52 pat
ients undergoing biliary tract surgery were analyzed retrospectively.
RESULTS: Simple regression revealed 24 factors with prognostic significance
, but multivariate analysis detected only 3 factors with independent signif
icance in predicting mortality (cholangitis, weight loss of 10kg or more an
d operative or post-operative blood transfusion). The presence of 2 of thes
e risk factors identified a group of patients with an 37% mortality rate.
CONCLUSIONS: The results of this study show that the presence of pre-operat
ive cholangitis, marked weight loss, and operative and post-operative blood
transfusion are associated with high postoperative mortality. The major ch
allenge is the prevention of cholangitis in high-risk patients, improvement
of the nutritional status of the patients, and avoidance of unnecessary bl
ood transfusions.