Less is better. The diagnostic workup of the patient with obstructive jaundice

The typical patient with suspected obstructive jaundice is often subjected to an extensive preoperative workup on the premise of providing surgeons with information that will aid them at exploration. A 15-year review of 83 patients with obstructive jaundice from the common periampullary carcinomas was carried out and indicated that obtaining such information was unnecessary, unsafe, costly, and time-consuming. It is recommended that the patient with a medical history and liver function test results suggestive of obstructive jaundice should undergo an abdominal ultrasound study. If this discloses distal bile duct obstruction, no further tests are necessary in most patients and the operation should be carried out promptly.