[Palliative cholangiojejunostomy on the duct of hepatic segment III. Our experience].
BACKGROUND
Aim of the paper is to prove that indications for cholangiojejunostomy, in cases when a mean and long term palliation may be expected, are better than those offered by the use of prostheses, without the well known and early bile duct complications.


METHODS
Between 1984 and 1995, 12 patients with obstructive jaundice due to malignancy at the hepatic hilum were treated by segment III Roux-en-y or omega cholangiojejunostomy. In 1 patient with no communication between right and left lobe of the liver, biliary-enteric bypass to segment VI duct was also undertaken; in another with neoplastic stenosis of pylorus gastrojejunostomy was performed. Seven patients had carcinoma of the gallbladder, three hilar cholangiocarcinoma, one gastric carcinoma and one recurrent pancreatic carcinoma.


RESULTS
There were two postoperative deaths, one for myocardial infarction and one for biliary peritonitis. Six patients had complications: four biliary fistulas with spontaneous resolution and two wound infections. Seven of the ten surviving patients experienced complete resolution of jaundice for at least 4 months. The mean survival of surviving patients was 9.7 months. Nine patients developed recurrent jaundice.


CONCLUSIONS
Segment III cholangiojejunostomy is a good palliative treatment in most patients with malignant hilar obstruction.
Confalonieri
F
F
Azienda USSL Ambito Territoriale N. 31, Presidio Ospedaliero Città di Sesto San Giovanni, Milano.
Ballerini
A
A
D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods / Q000401:mortality; D001650:Bile Duct Neoplasms / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D002423:Cause of Death; D002779:Cholestasis / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000601:surgery; D005260:Female; D006500:Hepatic Duct, Common / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D007582:Jejunostomy / Q000379:methods* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology
Colangiodigiunostomia palliativa sul dotto del 3o segmento epatico. La nostra esperienza.