Surgical vs nonsurgical jaundice. Differentiation by a combination of rose bengal I-131 and standard liver-function tests

Abstract

The distinction between surgical and nonsurgical jaundice has been hindered by lack of a reliable test for biliary tract obstruction or patency. To meet this need, a method was devised which uses rose bengal I-131 and external body monitoring to determine whether dye flows through the biliary tract into the intestine. Simultaneously, liver function was estimated by a rose bengal I-131 blood disappearance rate. Among 181 jaundiced patients, three results were nearly diagnostic: the combination of "good" liver function and complete biliary tract obstruction (surgical), "poor" liver function alone (nonsurgical), and a patent biliary tract (nonsurgical). The most useful result was the correct classification of difficult nonsurgical patients by the demonstration of biliary tract patency. Among nonsurgical patients having biochemical tests which were either indeterminate or wrong, 80% were correctly classified by this finding.