[Obstructive jaundice of benign and malignant origin: endoscopy in diagnosis and therapy]

Abstract

Laparoscopy and laparoscopic cholecysto-cholangiography for diagnosis of obstructive jaundice have been superseded by ERCP. ERCP is indicated in all patients with bilirubinaemia over 2 mg%. Surgery for obstructive jaundice should be abandoned in favour of surgery for common bile duct concretion, benign or malignant stenosis or periampullary neoplasia, as diagnosed by ERCP. Endoscopic sphincterotomy (EST) for recurrent common bile duct concretion is preferred in patients more than 60 years old. Biliary drainage techniques for litholysis or palliative tumour therapy have widely enlarged the spectrum of endoscopic surgery.