Home > Search Results

About - Jaundice

A condition in which the skin and the whites of the eyes become yellow, urine darkens, and the color of stool becomes lighter than normal. Jaundice occurs when the liver is not working properly or when a bile duct is blocked.

Results: 1 to 20 of 70

Early intravenous nutrition for the prevention of neonatal jaundice

Plain language summary will be included with future review update.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Antenatal phenobarbital for reducing neonatal jaundice after red cell isoimmunization

Inadequate evidence on antenatal use of phenobarbital for reducing jaundice in babies born to mothers whose blood is incompatible with the baby's blood.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Fibreoptic phototherapy for neonatal jaundice

A single fibreoptic phototherapy device is less effective at treating neonatal jaundice than conventional phototherapy, except in preterm infants in whom it is equally effective. Newborn infants often develop jaundice, which is concerning as unconjugated serum bilirubin can damage the developing brain. Since the 1960s, jaundice has been treated with phototherapy, for which the infants have to be naked in a crib with their eyes covered. Fibreoptic phototherapy is a new type of phototherapy in which the light is applied directly to the skin of the infant via optical fibres, enabling the infants to be nursed fully clothed near to their parents. This review has shown that fibreoptic phototherapy is less effective than conventional phototherapy, except in preterm infants in whom it is equally effective.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Immunoglobulin infusion for isoimmune haemolytic jaundice in neonates

Plain language summary will be included with future review update.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Prophylactic phototherapy for preventing jaundice in preterm very low birth weight infants

Preterm (< 37 weeks gestational age) or low birth weight (LBW; birth weight < 2500 g) infants have a greater risk of developing jaundice compared to term or normal birth weight infant. This can be concerning because jaundice (caused by high levels of serum unconjugated bilirubin) could lead to permanent brain damage and/or death.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Clofibrate for neonatal jaundice

Jaundice is a common problem in the neonatal period typically in the first week of life. It is treated quite effectively using phototherapy whereby the baby is placed under special lights for up to three to four days. Clofibrate is used in some countries in combination with phototherapy to reduce the time the baby needs to spend under lights thereby reducing parental anxiety and improved parent‐baby bonding opportunities.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Home‐ versus hospital‐based treatment for uncomplicated newborn jaundice in term infants

Newborn infants commonly develop a condition called jaundice. Jaundice occurs as the result of accumulation of a yellowish‐orange pigment called bilirubin in the skin and eyes. Bilirubin in increased concentrations can be damaging to the brain and can have profound long‐term detrimental effects. Phototherapy is a form of treatment used in newborns to reduce levels of bilirubin. "Home‐based phototherapy" can be used in the home setting with appropriate supervision. Home phototherapy is used only in cases of uncomplicated newborn jaundice. Home‐based phototherapy can offer certain advantages such as reduced hospital costs and improved bonding between an infant and mother. On the other hand, home‐based phototherapy could be associated with problems such as increased risk of the damaging effects of bilirubin on the brain and increased risk of readmission to hospital. In this Cochrane review, home‐based phototherapy was compared with hospital‐based phototherapy for uncomplicated jaundice in full‐term newborns. The review authors found no studies that met the eligibility criteria. The authors of this Cochrane review conclude that no high‐quality evidence is currently available to support or refute the use of home phototherapy for uncomplicated newborn jaundice.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Single versus double volume exchange transfusion in jaundiced newborn infants

Extremely high levels of bilirubin (severe jaundice) can lead to brain damage. Severe jaundice in newborns can occur as a result of a variety of causes including rhesus hemolytic disease, ABO incompatibility, atypical antibodies etc. Removal of blood from the affected infant and replacing with fresh blood from the blood bank (exchange transfusion) is used as a treatment for severe jaundice in newborn infants. The affected infant's blood is removed in small portions and equal volume of blood is replaced during exchange transfusion. Traditionally twice the blood volume of baby is removed and the replaced with fresh blood. Exchange transfusion has been shown to reduce brain damage in severely jaundiced babies; however, exchange transfusion is associated with serious adverse events including death. It is likely that the complications of exchange transfusion would increase with amount of blood exchanged. This review was undertaken to examine if single volume (removal of blood equivalent to the blood volume of the baby) is as effective as double volume (removal of twice blood volume of the baby) in reducing the brain damage and bilirubin levels in newborn infants with severe jaundice. Only one randomised trial fulfilled the criteria for inclusion in the analysis. This study compared single and double volume exchange transfusion in jaundice due to ABO hemolytic jaundice. The study found no significant difference in bilirubin levels following exchange. This study did not look at any long term neurodevelopmental outcome (brain damage). Based on the available data, there is insufficient evidence to support or refute the use of single volume exchange transfusion as opposed to double volume exchange transfusion in jaundiced newborns.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Effect of timing of umbilical cord clamping of term infants on mother and baby outcomes

At the time of birth, the infant is still attached to the mother via the umbilical cord, which is part of the placenta. The infant is usually separated from the placenta by clamping the cord. This clamping is one part of the third stage of labour (the time from birth of the baby until delivery of the placenta) and the timing can vary according to clinical policy and practice. Although early cord clamping has been thought to reduce the risk of bleeding after birth (postpartum haemorrhage), this review of 15 randomised trials involving a total of 3911 women and infant pairs showed no significant difference in postpartum haemorrhage rates when early and late cord clamping (generally between one and three minutes) were compared. There were, however, some potentially important advantages of delayed cord clamping in healthy term infants, such as higher birthweight, early haemoglobin concentration, and increased iron reserves up to six months after birth. These need to be balanced against a small additional risk of jaundice in newborns that requires phototherapy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Comparison of a light‐emitting diode with conventional light sources for providing phototherapy to jaundiced newborn infants

Jaundice, or yellowish discolouration of the skin, can occur due to increased amounts of bilirubin pigment in the blood. It is a commonly observed, usually harmless condition in newborn infants during the first week after birth. However, in some babies the amount of bilirubin pigment can increase to dangerous levels and require treatment. Treatment of jaundice in newborn infants is done by placing them under phototherapy, a process of exposing their skin to light of a specific wavelength band. Fluorescent tubes or halogen lamps have been used as light sources for phototherapy for many years. A light‐emitting diode (LED) is a newer type of light source which is power efficient, has a longer life and is portable with low heat production. In this systematic review, the efficacy of LED phototherapy was compared with conventional (non‐LED) phototherapy. LED phototherapy was observed to be efficacious in bringing down the levels of serum total bilirubin, at rates similar to phototherapy with conventional light sources.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Palliative biliary stents for obstructing pancreatic cancer

The majority of patients with cancer of the pancreas are diagnosed only after blockage of the bile ducts has occurred. Surgical by‐pass (SBP) or endoscopic stenting (ES) of the blockage are the treatment options available for these patients. This review compares 29 randomised controlled trials that used surgical by‐pass, endoscopic metal stents or endoscopic plastic stents in patients with malignant bile duct obstruction. All included studies contained groups where cancer of the pancreas was the most common cause of bile duct obstruction. This review shows that endoscopic stents are preferable to surgery in palliation of malignant distal bile duct obstruction due to pancreatic cancer. The choice of metal or plastic stents depends on the expected survival of the patient; metal stents only differ from plastic stents in the risk of recurrent bile duct obstruction. Polyethylene stents and stainless‐steel alloy stents (Wallstent) are the most studied stents.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Routine diversion of food for patients with unresectable periampullary cancers without obstruction to the stomach outlet

Periampullary cancer is cancer that forms near the junction of the lower end of the common bile duct (the channel that transmits bile from the liver to the small bowel), pancreatic duct, and the upper part of the small bowel. Four‐fifths of these tumours are not amenable to surgical removal (unresectable periampullary cancer). Because of its close proximity to the stomach outlet, these periampullary cancers can cause obstruction to the stomach outlet and prevent the flow of food from the stomach to the small bowel. While diversion of food by way of joining the stomach to the upper small bowel (gastrojejunostomy) or inserting a duodenal stent across the obstructed part of the small bowel is necessary for patients who have established stomach outlet obstruction, the role of prophylactic gastrojejunostomy in patients without established stomach outlet obstruction is controversial. The aim of this review was to determine whether prophylactic gastrojejunostomy should be performed routinely in patients with unresectable periampullary cancer. We searched for randomised controlled trials comparing prophylactic gastrojejunostomy versus no gastrojejunostomy in patients with unresectable periampullary cancer. Two review authors independently assessed the studies for inclusion and extracted data.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Biliary drainage before major operations in patients with obstruction of the bile duct

The liver has various functions, including the production and storage of substances necessary for the sustenance of life. It processes toxic substances (including those that are produced within the body because of the breakdown of old red cells) and plays a role in the excretion of these processed toxic substances. It produces bile, which contains substances necessary for the digestion of food. The bile is temporarily stored in the gallbladder and reaches the small bowel via the bile duct, usually in response to a stimulus such as ingestion of fatty food. The processed toxic substances are transported in the bile. These processed toxic substances are eventually excreted when the person opens his or her bowel. When there is obstruction to the flow of bile, the breakdown products of red cells can accumulate and cause yellowish discolouration of the skin and other linings in the body such as the white of the eyeball and the undersurface of the tongue. This results in a form of jaundice called obstructive jaundice. The obstruction to the bile flow is usually caused by stones in the common bile duct. These stones can originate from the gallbladder or from common bile duct stones. The majority of such stones can be treated endoscopically. However, a small proportion of the stones require surgery for removal. Other major causes of biliary obstruction include narrowing of the bile duct resulting from inflammation caused by stones, injury to the bile duct during operations to remove the gallbladder, and cancer of the bile duct, pancreas (an organ situated behind and below the stomach that secretes the digestive juices necessary for the digestion of food in addition to containing the cells that secrete insulin in order to maintain blood sugar levels), or the upper part of the small bowel called the duodenum. Operative removal is currently the only curative treatment available for these cancers. Such operations are typically major operations. However, the presence of toxic substances because of obstruction to the bile flow can result in physiological disturbances. Some surgeons perform certain procedures to temporarily drain the bile before performing the major operation to remove biliary obstruction due to stones, inflammation, or cancer. These pre‐operative procedures can be done endoscopically (by introducing an instrument equipped with a camera through the mouth and into the small intestine and then inserting a small drainage tube through that instrument and past the obstruction in the bile duct) or under X‐ray or other forms of image guidance via the liver. However, other surgeons argue that the temporary procedures to drain the bile are not necessary and that one should perform surgery directly. We sought evidence from randomised clinical trials only regarding this controversy. Such studies, when conducted properly, provide the best evidence. Two authors independently identified the trials and obtained the information from the trials.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Gallstones: Overview

We all have abdominal pain and digestion problems from time to time. In most cases they're harmless. But if you have cramping pain in your upper abdomen that comes in waves, you may have gallstones. Gallstones don't always cause colic, though, so they often go unnoticed.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: February 8, 2017

No evidence to assess surgical treatment in asymptomatic gallstones

Cholecystectomy is currently advised only for symptomatic gallstones. However, about 4% of patients with asymptomatic gallstones develop symptoms including cholecystitis, obstructive jaundice, pancreatitis, and gallbladder cancer. Literature search was performed for evidence from randomised clinical trials to find whether cholecystectomy was indicated in patients with silent (asymptomatic) gallstones. There is no randomised trial comparing cholecystectomy versus no cholecystectomy in silent gallstones. Further evaluation of observational studies, which measure outcomes such as obstructive jaundice, gallstone‐associated pancreatitis, and/or gall‐bladder cancer for sufficient duration of follow‐up is necessary before randomised trials are designed in order to evaluate whether cholecystectomy or no cholecystectomy is better for asymptomatic gallstones.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Metalloporphyrins for treatment of unconjugated hyperbilirubinemia in neonates

Metalloporphyrins may reduce very high levels of jaundice in newborn babies, but more research is required on safety and to compare it with other treatments. Jaundice is very common in newborn babies, and is caused by the liver producing too much bilirubin, a yellow‐coloured bile substance. A very high level of bilirubin can damage the developing brain, and is treated with phototherapy (light therapy) or exchange transfusions. Metalloporphyrins are drugs that can prevent the formation of bilirubin, but they might also cause photosensitivity (sensitivity to light) and anaemia (decreased hemoglobin levels in the blood). The review of trials found some evidence that metalloporphyrins might be able to reduce bilirubin, but more research is needed on short and long‐term effects and to compare it with other treatments.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Oral zinc for the prevention of hyperbilirubinaemia in neonates

Jaundice, or yellowish discolouration of the skin, can occur due to an increased amount of bilirubin pigment in the blood. It is a commonly observed and usually harmless condition in newborn infants during the first week after birth. However, in some babies, the amount of bilirubin pigment can increase to dangerous levels and necessitate treatment. Bilirubin is metabolised in the liver and is excreted via the intestine in faeces. Increased reabsorption of bilirubin from the intestine is one of the major factors inducing hyperbilirubinaemia in newborn infants. Oral zinc salt, a relatively harmless medicine, can reduce the bilirubin level in newborn infants by decreasing its reabsorption from the intestine.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Complications of gallstones

Gallstones are quite common in people over the age of 40. But most people don't notice them because the stones don't cause any symptoms. Treatment is usually only a good idea if there are noticeable symptoms. This is because that means there is a greater risk of complications.The possible complications of gallstones include inflammation of the gallbladder, bile duct or pancreas and obstruction of the bowel. Very large gallstones may increase the risk of gallbladder cancer and bile duct cancer. Each year about 1 out of 100 people who have typical gallbladder symptoms such as colic develop complications.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: February 8, 2017

Chest shielding to prevent patent ductus arteriosus in preterm infants receiving phototherapy

The ductus arteriosus is a fetal blood vessel that usually closes spontaneously after birth. However, in approximately 30% of infants born before 30 weeks gestation the vessel remains open (known as patent ductus arteriosus, or PDA), and the infant has problems with excess blood flow to the lungs, shunting of blood away from organs, and heart failure. Phototherapy is a common treatment for jaundice in preterm infants. However, phototherapy has been associated with failure of the closure of the ductus arteriosus in preterm infants.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Endoscopic ultrasound versus magnetic resonance cholangiopancreatography for the diagnosis of common bile duct stones

Bile, produced in the liver and stored temporarily in the gallbladder, is released into the small bowel on eating fatty food. The common bile duct (CBD) is the tube through which bile flows from the gallbladder to the small bowel. Stones in the CBD (CBD stones) are usually formed in the gallbladder before migration into the bile duct. They can obstruct the flow of bile leading to jaundice (yellowish discolouration of skin, whites of the eyes, and dark urine), infection of the bile (cholangitis), and inflammation of the pancreas (pancreatitis), which can be life threatening. Various diagnostic tests can be performed for the diagnosis of CBD stones. Depending upon the availability of resources, these stones are removed endoscopically (usually the case) or may be removed as part of the operation performed to remove the gallbladder (it is important to remove the gallbladder since the stones continue to form in the gallbladder and can cause recurrent problems). Prior to removal, invasive tests such as endoscopic retrograde cholangiopancreatography (ERCP) or intraoperative cholangiography (IOC) can be performed to detect CBD stones. However, before performing such invasive tests to diagnose CBD stones, non‐invasive tests such as endoscopic ultrasound (EUS) (using ultrasound attached to the endoscope) and magnetic resonance cholangiopancreatography (MRCP) are used to identify people at high risk of having CBD stones so that only those at high risk can be subjected to further tests.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Systematic Reviews in PubMed

See all (309)...

Systematic Review Methods in PubMed

See all (3)...

Recent Activity

    Your browsing activity is empty.

    Activity recording is turned off.

    Turn recording back on

    See more...