Palliative operation procedures for pancreatic head carcinoma.
OBJECTIVE
To investigate the procedure choice of palliative operation for carcinoma of the head of the pancreas (CHP).


METHODS
The clinical data from 187 patients with CHP treated in the last 20 years were analyzed retrospectively.


RESULTS
The operation mortality rate was 8.6%, the mortality of hepatic duct-jejunostomy (HDJS) was not higher than that of cholecystojejunostomy (CJS) (P>0.05). The postoperative relapse of jaundice and cholangitis was significantly lower than that of CJS (P<0.025), while the survival was apparently higher than that of CJS (P<0.01). The mortality of HJDS or CJS with gastrojejunostomy (GJS) was not significantly higher than that of the simple procedure without GJS (P>0.05), whereas the survival was significantly higher than that of the simple procedure without GJS (P<0.01). The occurrence of duodenal obstruction after HDJS or CJS was 29.3%.


CONCLUSIONS
As a palliative operation, Roux-en-Y choledochojejunostomy especially in combination with preventive gastrojejunostomy is strongly recommended.
Tao
Kai-Shan
KS
Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China. taokaishan@sina.com
Lu
Yong-Gang
YG
Dou
Ke-Feng
KF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000713:Anastomosis, Roux-en-Y / Q000401:mortality; D002767:Cholecystostomy; D005260:Female; D005500:Follow-Up Studies; D006500:Hepatic Duct, Common / Q000601:surgery; D006801:Humans; D007582:Jejunostomy / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D013270:Stomach / Q000601:surgery