Comparative Study of CT and Direct Cholangiogram for Evaluation of Obstructive Jaundice

Abstract

Introduction: The main aim of the study was to compare the findings of CT (computed tomography) and direct cholangiogram for the evaluation of obstructive jaundice.

Methods: A retrospective hospital based study was done among 62 patients with suspected biliary obstruction at Annapurna Neuro Hospital and TUTH from 2013 to 2015. CT scan of the abdomen and DC (PTC) were done in each patient. The level and cause of obstruction were evaluated by these modalitics.

Results:In this study, male to female ratio was 1:1.5 showing female predominance. The mean (+SD) age of the patients was 65.5 +15.6 years and range of from 28-94 years. CT and DC (PTC) identified hilum as the most common level of obstruction in71% and 69.4% of the patients. The most common malignancies were cholangiocarcinoma and gall bladder carcinoma, identified by CT and DC (PTC) respectively, which were present in over one third (35.5%) of the patients. Further, CT and DC (PTC) identify edpostoperative stricture as the most common benign aetiology in 6.4% and 4.8% of the patients respectively. Moreover, sensitivity of CT and DC (PTC) for malignant lesion 75% and 98% while specificity was 96.2% and 54.5% respectively (P value 0.000).

Conclusion: CT and DC (PTC) showed the almost similar accuracy in evaluating the level of obstruction at hilar region. Carcinoma of gall bladder and cholangiocarcinoma are the commonest malignancies whereas postoperative stricture was the commonest benign actiology. Early diagnosis and proper treatment will significantly reduce complication, morbidity and mortality rates.