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Surgical intervention is rarely indicated early in the course of postoperative jaundice. Mild to moderate hyperbilirubinemia is a frequent postoperative phenomenon which merits more observation than action. More severe jaundice may herald a catastrophic outcome due to factors outside the liver but reflected in progressive hepatocellular failure and often renal failure. Shock, sepsis, multiple transfusions, halogenated hydrocarbon anesthetics, and pre-existent liver disease are the factors most frequently associated with this condition. After three or four weeks more aggressive diagnostic measures are indicated, ranging from endoscopy with retrograde choledochopancreatography and transjugular hepatic biopsy and cholangiography to the measure of last resort, laparotomy.
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Presented at the Forty-Fifth Annual Meeting of the Pacific Coast Surgical Association, Kaanapali, Maui, Hawaii, February 17–21, 1974.
© 1974 Published by Elsevier Inc.