Verschlußikterus – palliative Drainage aus der Sicht des Chirurgen

Abstract

In jaundiced patients, the location and the extent of the biliary obstruction have to be defined. The indication for an invasive palliation depends on the ASA-classification, histo-pathology of the tumor, patient's age, tumor staging and the life expectancy. Three options are available today for palliation of obstructive jaundice: 1. The percutaneous transhepatic external or internal permanent catheter drainage, 2. the endoscopic insertion of biliary – duodenal stent – catheter and 3. the operative biliary-enteric bypass by either cholecysto- or hepatojejunostomy or the gastro- or jejunohepaticostomy. The advantage of a surgical biliary-enteric bypass in comparison to the stent implantation ist visible after more than 6 month, particularly in younger, fitter patients.