[Role of surgical biliary bypass for palliation of pancreatic cancer - a retrospective study of 107 cases].
BACKGROUNDS AND STUDY AIMS: At the time of diagnosis most patients with pancreatic cancer are still irresectable for cure. The aim of this study was to evaluate surgical palliation, in particular against the background of endoscopic stent placement.


METHODS
This retrospective study analyses the therapeutic results in 107 patients with an irresectable pancreatic carcinoma operated on between 1990 and 1998.


RESULTS
104 patients showed primary therapeutic success with adequate bile drainage. In 97 % a simultaneous gastrojejunostomy was performed. The overall complication rate was 24 % and the hospital mortality 3.7 %. Median survival after surgical treatment was 201 days.


CONCLUSIONS
Because of a decrease in perioperative morbidity and mortality, surgical palliation of irresectable pancreatic carcinoma still remains an effective therapy, especially for patients expected to survive 6 months or more. The surgical procedure offers the better chance for long-term palliation of obstructive jaundice and duodenal obstruction compared to the endoscopic approach. However, to consider both, the surgical and the endoscopic treatment, complementing each other, seems to be important to guarantee optimal palliation for the individual patient.
Stumpf
M
M
Chirurgische Klinik und Poliklinik, Medizinische Fakultät, Rheinisch-Westfälische Technische Hochschule, Aachen, Germany.
Kasperk
R
R
Bertram
P
P
Truong
S
S
Schumpelick
V
V
D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D000328:Adult; D000368:Aged; D015904:Biliopancreatic Diversion; D004322:Drainage; D004724:Endoscopy; D005260:Female; D005763:Gastroenterostomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors