Organization of the treatment of patients with obstructive malignant jaundice in the Komi Republic

Treatment effectiveness of patients with malignant biliary obstruction in the area with low density of population distribution is shown. Adopted 3 level care system. Level of care is determined by the diagnostic and treatment potentialities of a particular hospital. The objective of 1-st level is obstructive jaundice diagnostics. At the other two levels is carried topical diagnosis and surgical treatment. The difference between 2-nd and 3-rd levels is the possibility to perform percutaneous biliary drainage and radical surgical resection in 3rd level hospital. Cases of obstructive malignant jaundice in the Komi Republic for 2 periods (2000-2006 and 2007-2013 years) are analysed. In 2-nd period was introduced this scheme for routing patients. In 2-nd period increased surgical interventions proportion in 3-rd level hospital in Syktyvkar (from 51.2% to 70.2% at p