Management and outcomes of patients with obstructive jaundice from pancreatobiliary diseases in Rwanda
Abstract Background Obstructive jaundice from pancreatobiliary diseases represents a significant global health challenge, particularly in resource-limited settings like Rwanda. While endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic biliary drainage (PTBD) are now a...
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2025-07-01
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| Online Access: | https://doi.org/10.1186/s12876-025-04143-z |
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| author | Zainab Ingabire Aberra B. Hanna Emile Sebera Janvier Murayire Gamal S. Mohamed Eric Rutaganda Felicien Shikama Marie Solange Mukanumviye Dyna Nyampinga Innocenti Dadamessi Kulwinder Dua Redae Berhane |
| author_facet | Zainab Ingabire Aberra B. Hanna Emile Sebera Janvier Murayire Gamal S. Mohamed Eric Rutaganda Felicien Shikama Marie Solange Mukanumviye Dyna Nyampinga Innocenti Dadamessi Kulwinder Dua Redae Berhane |
| author_sort | Zainab Ingabire |
| collection | DOAJ |
| description | Abstract Background Obstructive jaundice from pancreatobiliary diseases represents a significant global health challenge, particularly in resource-limited settings like Rwanda. While endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic biliary drainage (PTBD) are now available at tertiary centers in Kigali, there is limited local clinical data on the management and outcomes of these conditions. This study aims to assess the patterns, therapeutic approaches, and outcomes of obstructive jaundice in the Rwandan healthcare context. Methods A cross-sectional study was conducted across three tertiary hospitals (KFH, RMH, and CHUK) in Rwanda from July 2023 to June 2024. Using Fischer’s formula, 158 patients with obstructive jaundice from pancreatobiliary diseases were enrolled. Data collection involved chart reviews at admission, procedure, post-procedure, discharge, and 30-day follow-up. Analysis was performed using Stata version 13, with descriptive statistics, bivariate analysis using chi-square, and multivariate analyses examining predictors of 30-days mortality among the participants at 95% confidence interval and p value < 0.05 considered statistically significant. Multicollinearity assessment was also performed considering the target variance inflation factor (VIF) < 5. Results In this study of 158 patients with obstructive jaundice in Rwanda, ERCP was the predominant intervention (77.54%), followed by PTBD (17.39%) and surgical procedures (5.07%). The overall procedures technical success rate was 82.61%; with PTBD success rate of 91.67%, surgical procedures showed higher success rate 100%, while ERCP had a success rate of 79.44%. Post-procedure complications occurred in 16.67% of cases, including pancreatitis (5%), bleeding (3.62%), and mortality (4.34%). The 30-day survival rate was 92.41%, demonstrating generally favorable outcomes in managing pancreaticobiliary diseases. The multivariate analysis showed that weight loss increased mortality risk (aOR = 10.647, 95% CI: 1.190-95.256, p = 0.034), while the absence of CBD stones was protective (aOR = 0.087, 95% CI: 0.008–0.888, p = 0.039). Having a procedure performed significantly reduced mortality odds (aOR = 0.025, 95% CI: 0.006–0.117, p < 0.001). ICU/HDU admission was associated with higher mortality risk in 30 days (aOR = 13.051, 95% CI: 2.010-84.731, p = 0.007). Conclusion This study from Rwanda provides crucial insights into the management and outcomes of obstructive jaundice from pancreatobiliary diseases. PTBD was demonstrated high success. While post-procedure complications occurred, the 30-day survival rate was favorable. Weight loss and ICU admission were associated with increased mortality, while procedural interventions showed protective effects, highlighting the importance of timely management. |
| format | Article |
| id | doaj-art-16185fa4fec640e5a40bd27e685d5699 |
| institution | DOAJ |
| issn | 1471-230X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | BMC Gastroenterology |
| spelling | doaj-art-16185fa4fec640e5a40bd27e685d56992025-08-20T03:05:21ZengBMCBMC Gastroenterology1471-230X2025-07-0125111410.1186/s12876-025-04143-zManagement and outcomes of patients with obstructive jaundice from pancreatobiliary diseases in RwandaZainab Ingabire0Aberra B. Hanna1Emile Sebera2Janvier Murayire3Gamal S. Mohamed4Eric Rutaganda5Felicien Shikama6Marie Solange Mukanumviye7Dyna Nyampinga8Innocenti Dadamessi9Kulwinder Dua10Redae Berhane11King Faisal Hospital RwandaKing Faisal Hospital RwandaKing Faisal Hospital RwandaKing Faisal Hospital RwandaRwanda Military HospitalUniversity Teaching Hospital of KigaliUniversity Teaching Hospital of ButareUniversity Teaching Hospital of KigaliUniversity Teaching Hospital of KigaliKing Faisal Hospital RwandaMedical College of WisconsinKing Faisal Hospital RwandaAbstract Background Obstructive jaundice from pancreatobiliary diseases represents a significant global health challenge, particularly in resource-limited settings like Rwanda. While endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic biliary drainage (PTBD) are now available at tertiary centers in Kigali, there is limited local clinical data on the management and outcomes of these conditions. This study aims to assess the patterns, therapeutic approaches, and outcomes of obstructive jaundice in the Rwandan healthcare context. Methods A cross-sectional study was conducted across three tertiary hospitals (KFH, RMH, and CHUK) in Rwanda from July 2023 to June 2024. Using Fischer’s formula, 158 patients with obstructive jaundice from pancreatobiliary diseases were enrolled. Data collection involved chart reviews at admission, procedure, post-procedure, discharge, and 30-day follow-up. Analysis was performed using Stata version 13, with descriptive statistics, bivariate analysis using chi-square, and multivariate analyses examining predictors of 30-days mortality among the participants at 95% confidence interval and p value < 0.05 considered statistically significant. Multicollinearity assessment was also performed considering the target variance inflation factor (VIF) < 5. Results In this study of 158 patients with obstructive jaundice in Rwanda, ERCP was the predominant intervention (77.54%), followed by PTBD (17.39%) and surgical procedures (5.07%). The overall procedures technical success rate was 82.61%; with PTBD success rate of 91.67%, surgical procedures showed higher success rate 100%, while ERCP had a success rate of 79.44%. Post-procedure complications occurred in 16.67% of cases, including pancreatitis (5%), bleeding (3.62%), and mortality (4.34%). The 30-day survival rate was 92.41%, demonstrating generally favorable outcomes in managing pancreaticobiliary diseases. The multivariate analysis showed that weight loss increased mortality risk (aOR = 10.647, 95% CI: 1.190-95.256, p = 0.034), while the absence of CBD stones was protective (aOR = 0.087, 95% CI: 0.008–0.888, p = 0.039). Having a procedure performed significantly reduced mortality odds (aOR = 0.025, 95% CI: 0.006–0.117, p < 0.001). ICU/HDU admission was associated with higher mortality risk in 30 days (aOR = 13.051, 95% CI: 2.010-84.731, p = 0.007). Conclusion This study from Rwanda provides crucial insights into the management and outcomes of obstructive jaundice from pancreatobiliary diseases. PTBD was demonstrated high success. While post-procedure complications occurred, the 30-day survival rate was favorable. Weight loss and ICU admission were associated with increased mortality, while procedural interventions showed protective effects, highlighting the importance of timely management.https://doi.org/10.1186/s12876-025-04143-zObstructive jaundiceCommon bile duct stonesERCPCholangiocarcinomaRwanda |
| spellingShingle | Zainab Ingabire Aberra B. Hanna Emile Sebera Janvier Murayire Gamal S. Mohamed Eric Rutaganda Felicien Shikama Marie Solange Mukanumviye Dyna Nyampinga Innocenti Dadamessi Kulwinder Dua Redae Berhane Management and outcomes of patients with obstructive jaundice from pancreatobiliary diseases in Rwanda BMC Gastroenterology Obstructive jaundice Common bile duct stones ERCP Cholangiocarcinoma Rwanda |
| title | Management and outcomes of patients with obstructive jaundice from pancreatobiliary diseases in Rwanda |
| title_full | Management and outcomes of patients with obstructive jaundice from pancreatobiliary diseases in Rwanda |
| title_fullStr | Management and outcomes of patients with obstructive jaundice from pancreatobiliary diseases in Rwanda |
| title_full_unstemmed | Management and outcomes of patients with obstructive jaundice from pancreatobiliary diseases in Rwanda |
| title_short | Management and outcomes of patients with obstructive jaundice from pancreatobiliary diseases in Rwanda |
| title_sort | management and outcomes of patients with obstructive jaundice from pancreatobiliary diseases in rwanda |
| topic | Obstructive jaundice Common bile duct stones ERCP Cholangiocarcinoma Rwanda |
| url | https://doi.org/10.1186/s12876-025-04143-z |
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