Failure to improve survival by improved diagnostic techniques in patients with malignant jaundice

In a consecutive series of 118 patients with malignant obstructive jaundice at North Tees General Hospital only 70 patients were adjudged fit to undergo surgery. Tumour resection was possible in only four patients. Palliative bypass was performed in 45 patients while 21 patients had no procedure other than an exploratory laparotomy. In contrast to the accuracy of investigation the results of surgery have been poor with considerable mortality (42.8 per cent) and lack of long-term survivors. The results emphasize the role of non-surgical methods for relieving jaundice of malignant aetiology, especially in frail elderly patients and those who have metastases at the time of presentation.