title: [Segmental bile duct bypass in obstruction of the liver hilus: only an alternative?].
abstract: Between 1987 and 1992 unilateral, segmental bilioenteric bypass-procedures (30 round ligament approach procedures, 4 peripheral bypass-procedures to the segment III bile duct and 3 to the segment V bile duct) were carried out in 37 icteric patients (twenty cholangio-carcinomas, 8 gallbladder-carcinomas, 6 other malignomas, 3 benign strictures). Postoperative complications were seen in 17 (46%) patients. The 30 day mortality rate was 3% (1/37). Relief of symptoms were achieved in 83% of patients. Objectively there was a significant postoperative reduction of serum bilirubin levels from mean 323 mumol/l to 109 mumol/(p < 0.005) and of the alkaline phosphatase from 708 U/l to 336 U/l (p < 0.005) respectively. This was achieved irrespectively of whether the segmental bypass was draining a segment only or the whole liver. Unilateral segmental bilioenteric bypass-procedures achieve an effective palliation in the majority of patients.
authors.affiliation: Universitätsklinik für Viszerale und Transplantationschirurgie, Inselspital, Bern.
authors.forename: C A
authors.initials: CA
authors.lastname: Maurer
authors.forename: T
authors.initials: T
authors.lastname: Dyong
authors.forename: H U
authors.initials: HU
authors.lastname: Baer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods*; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000601:surgery; D018281:Cholangiocarcinoma / Q000401:mortality / Q000601:surgery; D001651:Cholestasis, Extrahepatic / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D002780:Cholestasis, Intrahepatic / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005706:Gallbladder Neoplasms / Q000401:mortality / Q000601:surgery; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D015996:Survival Rate
vernacular_title: Der segmentale Gallengang-Bypass bei Obstruktion im Leberhilus: Nur eine Alternative?