J.Jpn. Surg. Soc.. 80(2): 93-97, 1979

---

Original article

CLASSIFICATION OF OBSTRUCTIVE JAUNDICE BASED ON THE BILIRUBIN DECREASING RATE "b" AND IT'S CLINICAL SIGNIFICANCE

We found a rule of the serum bilirubin changes after the biliary decompression in patients with severe jaundice. The rule is that after biliary decompression, serum bilirubin levels decreased lineally on the semilogarithmic graph-paper in every case examined just like the disappearance pattern of ICG or BSP. Then, relation of the serum bilirubin levels (Y) and the postoperative days (X) could be formularized as Y = ae^bx, where “a” was referred to the bilirubin level on the operative day ; “b”, the decreasing rate of serum bilirubin ; “e”, base of the natural logarithm. We classified the obstructive jaundice into four groups based on the bilirubin decreasing rate “b”, where the levels showed b＜ -0.9, -0.9＜ b＜ -0.05, -0.05＜b＜ -0.025, and b＜ -0.025 in groups 1, 2, 3, and 4, respectively. There were 13 cases in the group 1, 19 in the group 2, 14 in the group 3 and 16 in the group 4. The patients either with diabetes mellitus or severe cholangitis showed a tendency for a slow reduction pattern, that belonged to the group 4. As to the occurrence of post-operative complications, 3 among 14 cases of the group 3 and all sixteen cases of the group 4 showed the gastrointestinal bleeding or hepatic and renal failures. The postoperative complications, however, were rarely seen in either group 1 or 2.
1) The decreasing rate of serum bilirubin “b” corresponded quite well with severity of the disease and prognosis of the patients with obstructive jaundice.
2) Classification of obstructive jaundice based on the decreasing rate of bilirubin “b” is clinically very useful.

---

---

To read the PDF file you will need Adobe Reader installed on your computer.