Article Sidebar
Main Article Content
Abstract
Background: Differentiating benign from malignant extrahepatic obstructive jaundice before surgery determines whether patients are triaged towards curative or palliative treatment.
Objective: To evaluate the diagnostic accuracy of serum bilirubin and magnetic resonance cholangiopancreatography (MRCP) against histopathology.
Methods: This STARD-compliant, single-centre retrospective diagnostic-accuracy study included 50 consecutive adults treated at Dr. Mohammad Hoesin Central General Hospital, Palembang between January 2024 and December 2025. Serum bilirubin and MRCP were assessed against surgical or biopsy histopathology. Receiver-operating-characteristic analysis and 2×2 tables with Wilson 95% confidence intervals were computed.
Results: Thirty-nine patients (78%) had benign and 11 (22%) malignant aetiology. Direct bilirubin (13.7 vs 8.7 mg/dL; p=0.003), total bilirubin (20.17 vs 13.02 mg/dL; p=0.007), and common bile duct dilation (26.0 vs 18.5 mm; p=0.018) were higher in malignancy. Direct bilirubin had an AUC of 0.797 at 9.65 mg/dL; total bilirubin had an AUC of 0.773 at 14.3 mg/dL. MRCP had 94.9% specificity, 63.6% sensitivity, and 88.0% accuracy.
Conclusion: Serum bilirubin is a sensitive early rule-out marker, whereas MRCP is a highly specific confirmatory tool; their sequential use may improve pre-operative triage.
Keywords
Article Details
1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2.Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3.Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.