[Treatment of patients with obstructive jaundice in the flagship center].

Abstract

Objective: To improve treatment outcomes in patients with obstructive jaundice at the flagship center through distributing patient flows and applying optimal tactics.

Material and methods: A retrospective study included patients with obstructive jaundice between January 2022 and April 2024. Patients were divided into 2 groups: the main group - patients hospitalized between March 2023 and April 2024 (the first year of work of the flagship center); the control group - patients hospitalized between January 2022 and February 2023 (one year before the commissioning of the flagship center). In both groups, we analyzed gender- and age-adjusted distribution of patients, channels of hospitalization, severity of obstructive jaundice and its etiology, nature and number of surgical interventions, postoperative morbidity and mortality. Mean time to diagnosis, waiting time for surgery, postoperative and overall hospital-stay were compared.

Results: There was significantly lower postoperative morbidity in the main group (p<0.05). Moreover, the same group was characterized by significantly shorter time for diagnosis (3.4 versus 12.1 hours; p<0.0001), earlier surgical treatment (6.8 versus 17.4 hours; p<0.0001), postoperative (2.8 versus 5.7 days) and overall hospital-stay (3.6 versus 6.4 days).

Conclusion: The capabilities of the flagship center make it possible to provide specialized high-tech medical care within the first hours after admission, significantly reduce the time for correct diagnosis and period until surgery. Original algorithm for patient distribution and optimal tactics based on minimally invasive technologies significantly improved treatment outcomes in patients with obstructive jaundice.