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Vol 8, No 1 (2006)
Published online: 2006-03-17

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Cholecystocholedochoduonenal anastomosis in palliative surgery of non-resectable tumors of pancreatic head, Vater’s papilla and extrahepatic biliary tract

Krzysztof Ziaja, Krzysztof Szaniewski, Wacław Kuczmik, Damian Ziaja, Tomasz Orawczyk, Grzegorz Biolik
Chirurgia Polska 2006;8(1):55-63.

Abstract

Background: The authors present ten years experience in the surgical palliation of non-resectable tumors of the pancreatic head, Vater’s papilla and the extrahepatic biliary tract. Objective: an evaluation of different types of palliative biliary bypass procedures in patients with unresectable periampullary tumors.
Material and methods: 125 patients (46 females 79 males) on whom biliary anastomoses were performed from 1993 to 2002 in the Department of General and Vascular Surgery, at the Medical University of Silesia in Katowice. Additional gastrointestinal anastomoses were performed in 89 patients and in 27 cases, alcoholic splanchectomy. In 80 patients the presence of jaundice was found on admission. Perioperative diagnostics, type of biliary anastomosis performed, duration of jaundice withdrawal, perioperative complication rate, perioperative mortality and mean survival time were evaluated.
Results: The procedures’ durations were similar. No perioperative mortality was observed in the first 24 hours after surgery. The postoperative treatment was significantly shorter (p < 0.05) in the group after choledochocholecystoduodenostomy.
Conclusions: Quick biliary decompression and jaundice withdrawal, low perioperative mortality together with a low perioperative complication rate and quick postoperative recovery are the main advantages of palliative biliary bypass surgery. Choledochocholecystoduodenostomy is a good option for biliary decompression due to its low complication rate and short recovery time.

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Chirurgia Polska (Polish Surgery)