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Palliative surgery for unresectable pancreatic and periampullary cancer: a reappraisal.
- Source :
-
Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract [J Gastrointest Surg] 2006 Feb; Vol. 10 (2), pp. 286-91. - Publication Year :
- 2006
-
Abstract
- This study aimed to reappraise short-term and long-term results of palliative biliary and gastric bypass surgery in patients with unresectable pancreatic head carcinoma found at explorative laparotomy. We retrospectively analyzed 83 consecutive patients whose pancreatic head carcinoma appeared unresectable at laparotomy (vascular involvement [57%], liver metastases [24%], distant metastatic lymph nodes [11%], peritoneal implants [8%]) and who underwent palliative surgical concomitant biliary and gastric bypass. Postoperative mortality and morbidity rates were 4.8% and 26.5%, respectively. Postoperative-delayed gastric emptying occurred in 9 patients (10%). Antecolic (46%) and retrocolic (54%) gastrojejunostomies did not differ for the duration of nasogastric suction, the delay of oral intake, and the incidence of delayed gastric emptying. Mean hospital stay was 16 +/- 8 days. Median survival was 9 months (range 1-44). Late cholangitis occurred in 2 patients (2.4%) treated medically. One recurrent jaundice required transhepatic stenting 9 months from surgery. Four late gastric outlet obstructions occurred (4.8%) with a mean delay of 8 months from surgery. These data demonstrate that, in patients with unresectable pancreatic head carcinoma at laparotomy, palliative concomitant biliary and gastric bypass in a single procedure is safe and long-term efficient. This strategy remains to be compared to endoscopic palliation in this setting.
- Subjects :
- Biliopancreatic Diversion methods
Carcinoma secondary
Carcinoma surgery
Cholangitis etiology
Enteral Nutrition
Female
Follow-Up Studies
Gastric Bypass methods
Gastric Emptying physiology
Gastric Outlet Obstruction etiology
Humans
Intubation, Gastrointestinal
Length of Stay
Liver Neoplasms secondary
Lymphatic Metastasis pathology
Male
Middle Aged
Peritoneal Neoplasms secondary
Postoperative Complications
Retrospective Studies
Survival Rate
Treatment Outcome
Ampulla of Vater surgery
Common Bile Duct Neoplasms surgery
Palliative Care
Pancreatic Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1091-255X
- Volume :
- 10
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
- Publication Type :
- Academic Journal
- Accession number :
- 16455463
- Full Text :
- https://doi.org/10.1016/j.gassur.2005.05.011