A Reappraisal Of Common Bile Duct Obstruction In Jos Nigeria (1989-1999)

Objective: We aimed to reappraise the demographic characteristics, the clinical features, patholkogic effects, surgical management and outcome in patient with common bile duct obstruction. Methods: Records of patients seen in Jos University Teaching Hospital with common bile duct obstruction between 1989-1999 were evaluated and analysed. Results: Fourteen patients with mean age (range) of 30 (6-45) years and a sxe ratio, M:F of 3:1 had Benign Extrabiliary Tract Obstruction (MEBTO). The main associated disease condition in patients with BEBTO was cirrhosis of the liver (35%) versus diabetes ,ellitus (33%) in patients with MEBTO. Pain (85%), Jaundice (71%) and fever (35%) were the commonest clinical features for MEBTO. Causes of BEBTO were biliary calculi (72%) and chronic pancreatitis (28%) while MEBTO was caused by ductal caracinoma of the pancreas (100%). Positive mixed bile cultures in BEBTO were recorded in 86% of cases versus 45% for MEBTO. Surgical procedures performed in cases of BEBTO were biliary calculi extraction (65%), by pass choledochoduedenostomy (7%) and gastrocholecystojejunostomy for cases with chronic pancreatitis (28%). For MEBTO, cholecytojejunostomy was performed in 57% and triple by pass in 22% of cases. Postoperative wound infection occurred in 28% BEBTO versus 20% of MEBTO cases. Mortality in BEBTO was zero versus 62% for MEBTO. Conclusion: Although common bile duct obstruction occurs infrequently in our setting, this reappraisal highlights the distinct features of its demography, clinical manifestations, surgical management and outcome in the two groups of patients with condition. Key words: Benign, Malignant, Common bile duct, obstruction, evaluation. Highland Medical Research Journal Vol.1(2) 2002: 33-3