[Palliative biliodigestive anastomosis in non-resectable cancer of the head of the pancreas--with or without preventive gastroenterostomy?].
In 226 patients with malignant obstructive jaundice over a 10-year period (1975-1984) 92 presented with an unresectable carcinoma of the head of the pancreas and were treated with a palliative bilioenteric diversion: in 52 cases alone, in 20 cases with a therapeutic gastroenterostomy because of early duodenal obstruction, and in 20 cases with a simultaneous prophylactic gastroenterostomy. The latter did not increase perioperative morbidity (25% vs. 50% in bilioenteric diversion alone), mortality (5% vs. 19%) nor length of hospital stay (19.9 vs. 20.6 days). Later on patients with a prophylactic gastroenterostomy showed a decreased incidence of chronic vomiting (15% vs. 42%). No secondary gastroenterostomy was performed in this group, vs. 14% (6 patients) in cases with bilioenteric diversion alone (mortality 33%). We recommend the simultaneous prophylactic gastroenterostomy which does not increase morbidity, mortality and length of hospital stay and helps avoiding a risky secondary gastroenterostomy.
Roost
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HM
Ackermann
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Harder
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D000368:Aged; D001652:Bile Ducts / Q000601:surgery; D001651:Cholestasis, Extrahepatic / Q000601:surgery*; D005260:Female; D005763:Gastroenterostomy / Q000379:methods*; D006801:Humans; D008297:Male; D010166:Palliative Care / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality; D011379:Prognosis
Palliative biliodigestive Anastomose bei nicht resektablem Pankreaskopfkarzinom--mit oder ohne prophylaktische Gastroenterostomie?