Liver function trends after biliary decompression in obstructive jaundice: a clinico-pathological-biochemical study


  • Mohan Lal Department of General Surgery, Government Medical College, Pali, Rajasthan, India
  • Prabhu Dayal Department of General Surgery, Government Medical College, Pali, Rajasthan, India



Biliary-decompression, Liver function trends, Obstructive jaundice


Background: Liver functions tests suggest the underlying cause, estimate the severity, assess prognosis and monitor efficacy of therapy. Severity of liver dysfunction when performed serially may predict prognosis and may be helpful in assessing response to medical therapy or a surgical intervention.

Methods: The data was collected in thirty cases of surgical obstructive jaundice in terms of age, sex, etiology, clinical presentation, surgical intervention for biliary drainage and the laboratory liver biochemical and coagulation profiles on a day prior to surgical intervention and post-operatively on 1st week and 4th week were recorded.

Results: Of total 30 patients 56.66% were females. Patients with 73.68% of benign disease and 100% of malignant disease were of age more than 40 years. 63.33% of patients had benign cause for biliary obstruction. Choledochoithiasis and periampullary carcinoma were two most common causes of obstructive jaundice. The commonest complaints were; yellowish discolouration of sclera and skin, high colored urine (100%) and acholic stool (70%). Hepatomegaly, palpable gallbladder and ascites were observed in only malignant conditions. Serum bilirubin and transaminases were significantly higher in patients with malignant lesions on pre-operative and postoperative assessment. After decompression the rate of fall of serum bilirubin, serum glutamic-oxaloacetic transaminase and SGPT were almost identical in both benign and malignant biliary obstructions. However, a better biochemical recovery profile was observed in patients with benign lesions, as they returned to normal by 4 weeks but remained at 2 to 3 times of the normal in malignant lesions.

Conclusions: Sequential biochemical assessment of liver functions has diagnostic as well as prognostic value in surgical obstructive jaundice.


Sharma R, Patnaik PK, Pujari PS; Pattern of liver biochemical profile restoration following biliary decompression in benign and malignant conditions. Sch J App Med Sci. 2015;3(2):833-42.

Bari S, Malik AA, Wani KA. Role of pre-opreative biliary drainage in benign surgical obstructive jaundice. JK-Practitioner. 2014;19(1-2):11-20.

Assimakopoulos SF, Scopa CD, Vagianos CE. Pathophysiology of increased intestinal permeability in obstructive jaundice. World J Gastroenterol. 2007;13(48):6458-64.

Bhargava SK, Usha T, Bhatt S, Kumari R, Bhargava S. Imaging in Obstructive Jaundice: A review with our experience. JIMSA. 2013;26(1):43-6.

Irabor DO. The pattern of fall of serum bilirubin after operative relief of obstructive jaundice. A preliminary report. Rev Cienc Salud Bogotá (Colombia). 2009;7(2):8-14.

Fiori E, Atella F, Gazzanelli S, Masi ED, Lamazza A, Cangemi V, et al. The usefulness of biliary drainage for restoring liver function in obstructive jaundice. Panminerva Med. 1994;36:171-8.

Shukla S, Kharat PR, Patbamniya N, Kumar K. Clinicopathological study on patients presenting with obstructive jaundice. Int Surg J. 2018;5(2):705-10.

Gupta AK, Singh A, Goel S, Tank R. Profile and pattern of obstructive jaundice cases from a tertiary care teaching hospital of Uttar Pradesh. Int Surg J. 2017;4(2):743-6.

Saddique M, Iqbal SA. Management of obstructive jaundice: experience in a tertiary care surgical unit. Pakistan J Surg. 2007;23(1):23-5.

Athlin L, Blind PJ, Eriksson S. The value of biochemical tests in disriminating between malignant and benign pancreatic tumors. HPB Surg. 1994;4(2):147-55.

Wiwanitkit V. High serum alkaline phosphatise levels, a study in 181 Thai adult hospitalized patients. BMC Family Practice. 2001;2:2.






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