title: [Efficacy of biliary by-pass operations in carcinoma of the head of the pancreas with jaundice (author's transl)].
abstract: In the present state of detection and treatment of carcinoma of the head of the pancreas, only palliative surgery is available. The debate concerning the type of bilio-digestive by-pass is far from closed. Although by-passes using the gall bladder remain rare in France, above all reserved for advanced cancer, we prefer to use the common bile duct. The choice of the by-pass depends mainly on the local conditions and on the general state of the patient. Side-to-side choledoco-duodenal anastomosis, provided the technic is perfect and there is no duodenal obstruction, remains the simplest and therefore the most commonly used by-pass. However in cases of large pancreatic carcinomas modifying the relations between the duodenum and the bile duct or stenosing the duodenum, or as a routine whenever possible, it seems to us advisable to undertake a choledoco-jejunostomy on a Y loop (the raised loop is also used for a gastrojejunostomy), and this seems to give the most rapid recovery from the jaundice, a low mortality and ensure the longest survival.
mesh_terms: D000368:Aged; D002779:Cholestasis / Q000209:etiology / Q000601:surgery*; D003135:Common Bile Duct / Q000601:surgery*; D004386:Duodenum / Q000601:surgery*; D005260:Female; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008722:Methods; D008875:Middle Aged; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000150:complications / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications
vernacular_title: Efficacité des dérivations biliaires dans les cancers ictérigènes de la tête du pancréas.