Cohort Study of Surgical Bypass to the Gallbladder or Bile Duct for the Palliation of Jaundice due to Pancreatic Cancer

Urbach, David R.; Bell, Chaim M.; Swanström, Lee L.; Hansen, Paul

doi:10.1097/00000658-200301000-00012

Cited by 52 publications

(25 citation statements)

References 23 publications

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“…However, while short-term outcomes of gallbladder and common bile duct enteroanastomoses do not differ significantly from choledochojejunostomy, it is well documented that, in the long run, common bile duct anastomosis provides more durable palliation of obstructive jaundice than gall bladder anastomosis. Gall bladder bypass is associated with a substantially greater risk of subsequent biliary drainage procedures than bile duct bypass in patients with pancreatic cancer [18]. The reason for this lies in the frequently occurring inclusion of the cystic duct in the case of tumor progression.…”

Section: Biliary Obstruction and Jaundicementioning

confidence: 99%

Surgical palliation in patients with pancreatic cancer

Köninger

Wente

Müller

et al. 2006

Langenbecks Arch Surg

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Section: Biliary Obstruction and Jaundicementioning

confidence: 99%

Surgical palliation in patients with pancreatic cancer

Köninger

Wente

Müller

et al. 2006

Langenbecks Arch Surg

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“…Di Carlo et al [11] reported there was no significant difference in the frequency of locally advanced or metastatic disease www.wjgnet.com [12,13] . Although endoscopic stenting of the bile duct or PTBD can relieve biliary obstruction, surgical bypass is done in many cases because of patient or physician preference, an inability to access the bile duct, or failure of non-surgical palliation [14] . Surgical bypass can also be performed when a pancreatic head cancer proves to be unresectable during an operation intended to cure the tumor.…”

Section: Discussionmentioning

confidence: 99%

Surgical palliation of unresectable pancreatic head cancer in elderly patients

Hwang¹,

Kim²,

Son³

et al. 2009

WJG

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AIM:To determine if surgical biliary bypass would provide improved quality of residual life and safe palliation in elderly patients with unresectable pancreatic head cancer. METHODS:Nineteen patients, 65 years of age or older, were managed with surgical biliary bypass (Group A). These patients were compared with 19 patients under 65 years of age who were managed with surgical biliary bypass (Group B). In addition, the results for group A were compared with those obtained from 17 patients, 65 years of age or older (Group C), who received percutaneous transhepatic biliary drainage to evaluate the quality of residual life. RESULTS:Five patients (26.0%) in Group A had complications, including one intraabdominal abscess, one pulmonary atelectasis, and three wound infections. One death (5.3%) occurred on postoperative day 3. With respect to morbidity, mortality, and postoperative hospitalization, no statistically significant difference was noted between Groups A and B. The number of readmissions and the rate of recurrent jaundice were lower in Group A than in Group C, to a statistically significant degree (P = 0.019, P = 0.029, respectively).The median hospital-free survival period and the median overall survival were also significantly longer in Group A (P = 0.001 and P < 0.001, respectively). CONCLUSION:Surgical palliation does not increase the morbidity or mortality rates, but it does increase the survival rate and improve the quality of life in elderly patients with unresectable pancreatic head cancer.

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“…Although technically straightforward, trends in open surgery favour bypass to the bile duct over cholecystojejunostomy [21] . Laparoscopic choledochojejunostomy has been reported but the experience remains limited.…”

Section: Discussionmentioning

confidence: 99%