[Surgical strategy in the management of benign obstructive jaundice]

623 patients with benign biliary obstructions of extrahepatic biliary ducts were treated in surgical clinic number 2 during the period of 1990-2002 years. Surgical treatment included 3 stages: (1) diagnosis of benign biliary obstructions; (2) preoperative biliary tree decompression; (3) definitive surgical resolve. Definitive diagnosis was established in 90% of cases after cholangiopancreatography retrograde endoscopic (CPGRE), in 7% of cases was used cholangiography transhepatic percutaneous with using ultrasonography, which was the method of choice in cases with high obstructions, and with gastric resections in anamnesis. In 22 cases with negative results of applied methods was used MRI of biliary tract, with permitted positive solution of problem. Surgical tactics was in direct dependency from pathology, level of obstruction, grade of clinical manifestation of the disease. In all cases was applied staged treatment, with permitted in pre-operative period to resolve the jaundice, biliary infection and correction of hepatic function with following surgical definitive correction with minimal risk of postoperative complications. The total lethality was 9 (1.44 %) patients.