Etiology of Common Bile Duct Strictures in Patients Presenting With Obstructive Jaundice at a Tertiary Care Military Hospital

Objective: To assess common bile duct stricture etiology and its association with patient age, gender, and stricture location in patients presenting with obstructive jaundice. Study Design: Cross-sectional analytical study Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi, Pakistan, from Feb 24 to Jan 25. Methodology: Patients with obstructive jaundice (n=96) and confirmed CBD strictures were included. Strictures were classified by location (proximal/mid/distal) and etiology (malignant/benign) using ultrasonography, CT, and ERCP. Inter-rater reliability was confirmed (κ=0.85). Data were analyzed using SPSS v27, and the Pearson chi-square test was used for associations (p<0.05). Results: The mean age of patients was 55.28 ± 8.96 years, with the majority being male (59.4%). Distal strictures were most prevalent (56.3%), followed by proximal and general strictures (18.8% each), and mid-CBD strictures were the least common (6.3%). Malignancy was the leading cause, and specifically, cholangiocarcinoma was present in 31.3% of 62.6% of malignant cases. There were strong associations between stricture location and etiology (p<0.001), and age and stricture etiology (p<0.001). Conclusions: The study found that malignant etiologies dominate CBD strictures, particularly in distal locations and older patients. Hence, early malignancy screening must be done for distal strictures, and age-specific diagnostic approaches must be designed for better health outcomes. Multicenter studies should be done to further validate the findings in diverse populations.