title: Palliative bypass surgery in carcinoma of the head of the pancreas.
abstract: A review of 52 patients having palliative bypass surgery for carcinoma of the head of the pancreas revealed that 20% of patients required subsequent laparotomy for relief of gastric outlet obstruction and that biliary-enteric anastomoses using the gall bladder were unsatisfactory in 25% of patients. It is recommended that gastroenterostomy be performed routinely during the initial laparotomy. The biliary anatomy should be demonstrated by pre-operative or intra-operative contrast X-rays and the gall bladder should be used for biliary-enteric anastomosis only when the surgeon is certain that the biliary system will be adequately drained.
mesh_terms: D000368:Aged; D002758:Cholangiography; D005260:Female; D005500:Follow-Up Studies; D005704:Gallbladder / Q000601:surgery; D006801:Humans; D007421:Intestine, Small / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D013270:Stomach / Q000601:surgery