Biliary and duodenal bypass for carcinoma of the head of the pancreas

✍ Scribed by Ian R. Gough; Geoffrey Mumme

• Publisher: John Wiley and Sons
• Year: 1984
• Tongue: English
• Weight: 269 KB
• Volume: 26
• Category: Article
• ISSN: 0022-4790
• DOI: 10.1002/jso.2930260416

✦ Synopsis

A review was undertaken of 66 patients having palliative bypass surgery for carcinoma of the head of the pancreas. A second laparotomy for relief of duodenal obstruction was necessary in six of 29 (20%) of the patients who did not have gastroenterostomy performed initially, but late gastric outlet obstruction occurred only once in 37 patients having an initial gastroenterostomy (P < 0.05). Cholecystojejunostomy failed to provide permanent biliary bypass in 14 of 53 (26%) patients, compared to successful drainage in all 13 patients having anastomosis of the common hepatic duct to the jejunum (P < 0.05). In seven patients cholecystojejunostomy was performed when the cystic duct was already obstructed by tumour. Therefore prophylactic gastrojejunostomy is recommended as a routine. The gallbladder should only be used for biliary bypass when appropriate contrast x-rays have demonstrated the patency of the cystic duct.