Palliative operations for pancreatic carcinoma
Identifieur interne : 001611 ( Istex/Corpus ); précédent : 001610; suivant : 001612Palliative operations for pancreatic carcinoma
Auteurs : John R. Potts Iii ; Thomas A. Broughan ; Robert E. HermannSource :
- The American Journal of Surgery [ 0002-9610 ] ; 1990.
Abstract
Controversies in palliation of pancreatic carcinoma include the best biliary bypass, the best gastric bypass, and how routinely gastric bypass should be used. We reviewed the records of 142 patients who underwent palliative operations for pancreatic carcinoma at the Cleveland Clinic over a 5-year period. Direct choledochal-enteric anastomosis proved superior to cholecystojejunostomy because of the high incidence of postoperative biliary sepsis and obstruction with the latter. The lowest incidence of these complications was achieved with choledochoduodenostomy. Loop gastrojejunostomy and Roux-Y gastrojejunostomy resulted in similar complication rates and postoperative stays, but, because loop reconstruction was simpler, it was deemed superior. Blood loss, operative time, and hospital stay were similar in patients with loop gastrojejunostomy and patients with no gastric bypass. This finding, coupled with a 10% incidence of subsequent gastric outlet obstruction in those without gastric bypass, indicates that gastric bypass should be liberally applied in the palliation of pancreatic carcinoma.
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DOI: 10.1016/S0002-9610(05)80609-9
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Palliative operations for pancreatic carcinoma</title><author><name sortKey="Potts Iii, John R" sort="Potts Iii, John R" uniqKey="Potts Iii J" first="John R." last="Potts Iii">John R. Potts Iii</name><affiliation><mods:affiliation>Ft. Lauderdale, Florida, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Requests for reprints should be addressed to John R. Potts III, MD, Department of General Surgery, Cleveland Clinic Florida, 3000 West Cypress Creek Road, Ft. Lauderdale, Florida 33309.</mods:affiliation></affiliation><affiliation><mods:affiliation>1From the Department of General Surgery, Cleveland Clinic Florida, Ft. Lauderdale, Florida, and the Department of General Surgery, Cleveland Clinic Foundation, Cleveland, Ohio.</mods:affiliation></affiliation></author><author><name sortKey="Broughan, Thomas A" sort="Broughan, Thomas A" uniqKey="Broughan T" first="Thomas A." last="Broughan">Thomas A. Broughan</name><affiliation><mods:affiliation>Cleveland, Ohio, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>1From the Department of General Surgery, Cleveland Clinic Florida, Ft. Lauderdale, Florida, and the Department of General Surgery, Cleveland Clinic Foundation, Cleveland, Ohio.</mods:affiliation></affiliation></author><author><name sortKey="Hermann, Robert E" sort="Hermann, Robert E" uniqKey="Hermann R" first="Robert E." last="Hermann">Robert E. Hermann</name><affiliation><mods:affiliation>Cleveland, Ohio, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>1From the Department of General Surgery, Cleveland Clinic Florida, Ft. 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Lauderdale, Florida, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Requests for reprints should be addressed to John R. Potts III, MD, Department of General Surgery, Cleveland Clinic Florida, 3000 West Cypress Creek Road, Ft. Lauderdale, Florida 33309.</mods:affiliation></affiliation><affiliation><mods:affiliation>1From the Department of General Surgery, Cleveland Clinic Florida, Ft. Lauderdale, Florida, and the Department of General Surgery, Cleveland Clinic Foundation, Cleveland, Ohio.</mods:affiliation></affiliation></author><author><name sortKey="Broughan, Thomas A" sort="Broughan, Thomas A" uniqKey="Broughan T" first="Thomas A." last="Broughan">Thomas A. Broughan</name><affiliation><mods:affiliation>Cleveland, Ohio, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>1From the Department of General Surgery, Cleveland Clinic Florida, Ft. Lauderdale, Florida, and the Department of General Surgery, Cleveland Clinic Foundation, Cleveland, Ohio.</mods:affiliation></affiliation></author><author><name sortKey="Hermann, Robert E" sort="Hermann, Robert E" uniqKey="Hermann R" first="Robert E." last="Hermann">Robert E. Hermann</name><affiliation><mods:affiliation>Cleveland, Ohio, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>1From the Department of General Surgery, Cleveland Clinic Florida, Ft. Lauderdale, Florida, and the Department of General Surgery, Cleveland Clinic Foundation, Cleveland, Ohio.</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">The American Journal of Surgery</title><title level="j" type="abbrev">AJS</title><idno type="ISSN">0002-9610</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1990">1990</date><biblScope unit="volume">159</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="72">72</biblScope><biblScope unit="page" to="78">78</biblScope></imprint><idno type="ISSN">0002-9610</idno></series><idno type="istex">A840F4F994C4E60E67E2407D8EC667D804C2FE8C</idno><idno type="DOI">10.1016/S0002-9610(05)80609-9</idno><idno type="PII">S0002-9610(05)80609-9</idno><idno type="ArticleID">05806099</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0002-9610</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Controversies in palliation of pancreatic carcinoma include the best biliary bypass, the best gastric bypass, and how routinely gastric bypass should be used. We reviewed the records of 142 patients who underwent palliative operations for pancreatic carcinoma at the Cleveland Clinic over a 5-year period. Direct choledochal-enteric anastomosis proved superior to cholecystojejunostomy because of the high incidence of postoperative biliary sepsis and obstruction with the latter. The lowest incidence of these complications was achieved with choledochoduodenostomy. Loop gastrojejunostomy and Roux-Y gastrojejunostomy resulted in similar complication rates and postoperative stays, but, because loop reconstruction was simpler, it was deemed superior. Blood loss, operative time, and hospital stay were similar in patients with loop gastrojejunostomy and patients with no gastric bypass. This finding, coupled with a 10% incidence of subsequent gastric outlet obstruction in those without gastric bypass, indicates that gastric bypass should be liberally applied in the palliation of pancreatic carcinoma.</div></front></TEI><istex><corpusName>elsevier</corpusName><author><json:item><name>John R. Potts, III MD, FACS</name><affiliations><json:string>Ft. Lauderdale, Florida, USA</json:string><json:string>Requests for reprints should be addressed to John R. Potts III, MD, Department of General Surgery, Cleveland Clinic Florida, 3000 West Cypress Creek Road, Ft. Lauderdale, Florida 33309.</json:string><json:string>1From the Department of General Surgery, Cleveland Clinic Florida, Ft. Lauderdale, Florida, and the Department of General Surgery, Cleveland Clinic Foundation, Cleveland, Ohio.</json:string></affiliations></json:item><json:item><name>Thomas A. 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We reviewed the records of 142 patients who underwent palliative operations for pancreatic carcinoma at the Cleveland Clinic over a 5-year period. Direct choledochal-enteric anastomosis proved superior to cholecystojejunostomy because of the high incidence of postoperative biliary sepsis and obstruction with the latter. The lowest incidence of these complications was achieved with choledochoduodenostomy. Loop gastrojejunostomy and Roux-Y gastrojejunostomy resulted in similar complication rates and postoperative stays, but, because loop reconstruction was simpler, it was deemed superior. Blood loss, operative time, and hospital stay were similar in patients with loop gastrojejunostomy and patients with no gastric bypass. 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Lauderdale, Florida, USA</affiliation><affiliation>Requests for reprints should be addressed to John R. Potts III, MD, Department of General Surgery, Cleveland Clinic Florida, 3000 West Cypress Creek Road, Ft. Lauderdale, Florida 33309.</affiliation><affiliation>1From the Department of General Surgery, Cleveland Clinic Florida, Ft. Lauderdale, Florida, and the Department of General Surgery, Cleveland Clinic Foundation, Cleveland, Ohio.</affiliation></author><author><persName><forename type="first">Thomas A.</forename><surname>Broughan</surname></persName><roleName type="degree">MD, FACS</roleName><affiliation>Cleveland, Ohio, USA</affiliation><affiliation>1From the Department of General Surgery, Cleveland Clinic Florida, Ft. 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We reviewed the records of 142 patients who underwent palliative operations for pancreatic carcinoma at the Cleveland Clinic over a 5-year period. Direct choledochal-enteric anastomosis proved superior to cholecystojejunostomy because of the high incidence of postoperative biliary sepsis and obstruction with the latter. The lowest incidence of these complications was achieved with choledochoduodenostomy. Loop gastrojejunostomy and Roux-Y gastrojejunostomy resulted in similar complication rates and postoperative stays, but, because loop reconstruction was simpler, it was deemed superior. Blood loss, operative time, and hospital stay were similar in patients with loop gastrojejunostomy and patients with no gastric bypass. This finding, coupled with a 10% incidence of subsequent gastric outlet obstruction in those without gastric bypass, indicates that gastric bypass should be liberally applied in the palliation of pancreatic carcinoma.</p></abstract></profileDesc><revisionDesc><change when="1990">Published</change></revisionDesc></teiHeader></istex:fulltextTEI></fulltext><metadata><istex:metadataXml wicri:clean="Elsevier doc found" wicri:toSee="Elsevier, no converted or simple article"><istex:xmlDeclaration>version="1.0" encoding="UTF-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//ES//DTD journal article DTD version 5.0.1//EN//XML" URI="art501.dtd" name="istex:docType"></istex:docType><istex:document><article version="5.0" xml:lang="en" docsubtype="fla"><item-info><jid>AJS</jid><aid>05806099</aid><ce:pii>S0002-9610(05)80609-9</ce:pii><ce:doi>10.1016/S0002-9610(05)80609-9</ce:doi><ce:copyright type="unknown" year="1990">Reed Publishing USA</ce:copyright></item-info><head><ce:article-footnote><ce:label>**</ce:label><ce:note-para>Presented at the 30th Annual Meeting of the Society for Surgery of the Alimentary Tract, Washington, D.C., May 16–17, 1989.</ce:note-para></ce:article-footnote><ce:title>Palliative operations for pancreatic carcinoma</ce:title><ce:author-group><ce:author><ce:degrees>MD, FACS</ce:degrees><ce:given-name>John R.</ce:given-name><ce:surname>Potts</ce:surname><ce:suffix>III</ce:suffix><ce:cross-ref refid="aff1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="fn1"><ce:sup loc="post">1</ce:sup></ce:cross-ref><ce:cross-ref refid="cor1"><ce:sup loc="post">*</ce:sup></ce:cross-ref></ce:author><ce:author><ce:degrees>MD, FACS</ce:degrees><ce:given-name>Thomas A.</ce:given-name><ce:surname>Broughan</ce:surname><ce:cross-ref refid="aff2"><ce:sup loc="post">b</ce:sup></ce:cross-ref><ce:cross-ref refid="fn1"><ce:sup loc="post">1</ce:sup></ce:cross-ref></ce:author><ce:author><ce:degrees>MD, FACS</ce:degrees><ce:given-name>Robert E.</ce:given-name><ce:surname>Hermann</ce:surname><ce:cross-ref refid="aff2"><ce:sup loc="post">b</ce:sup></ce:cross-ref><ce:cross-ref refid="fn1"><ce:sup loc="post">1</ce:sup></ce:cross-ref></ce:author><ce:affiliation id="aff1"><ce:label>a</ce:label><ce:textfn>Ft. Lauderdale, Florida, USA</ce:textfn></ce:affiliation><ce:affiliation id="aff2"><ce:label>b</ce:label><ce:textfn>Cleveland, Ohio, USA</ce:textfn></ce:affiliation><ce:correspondence id="cor1"><ce:label>*</ce:label><ce:text>Requests for reprints should be addressed to John R. Potts III, MD, Department of General Surgery, Cleveland Clinic Florida, 3000 West Cypress Creek Road, Ft. Lauderdale, Florida 33309.</ce:text></ce:correspondence><ce:footnote id="fn1"><ce:label>1</ce:label><ce:note-para>From the Department of General Surgery, Cleveland Clinic Florida, Ft. Lauderdale, Florida, and the Department of General Surgery, Cleveland Clinic Foundation, Cleveland, Ohio.</ce:note-para></ce:footnote></ce:author-group><ce:abstract id="ab1" class="author" xml:lang="en"><ce:abstract-sec><ce:simple-para view="all" id="simple-para.0010">Controversies in palliation of pancreatic carcinoma include the best biliary bypass, the best gastric bypass, and how routinely gastric bypass should be used. We reviewed the records of 142 patients who underwent palliative operations for pancreatic carcinoma at the Cleveland Clinic over a 5-year period. Direct choledochal-enteric anastomosis proved superior to cholecystojejunostomy because of the high incidence of postoperative biliary sepsis and obstruction with the latter. The lowest incidence of these complications was achieved with choledochoduodenostomy. Loop gastrojejunostomy and Roux-Y gastrojejunostomy resulted in similar complication rates and postoperative stays, but, because loop reconstruction was simpler, it was deemed superior. Blood loss, operative time, and hospital stay were similar in patients with loop gastrojejunostomy and patients with no gastric bypass. This finding, coupled with a 10% incidence of subsequent gastric outlet obstruction in those without gastric bypass, indicates that gastric bypass should be liberally applied in the palliation of pancreatic carcinoma.</ce:simple-para></ce:abstract-sec></ce:abstract></head><tail view="all"><ce:bibliography view="all" id="bibliography.0010"><ce:section-title>References</ce:section-title><ce:bibliography-sec id="bibliography-sec.0010"><ce:bib-reference id="bib1"><ce:label>1.</ce:label><sb:reference><sb:contribution langtype="en"><sb:authors><sb:author><ce:surname>Forrest</ce:surname><ce:given-name>JF</ce:given-name></sb:author><sb:author><ce:surname>Longmire</ce:surname><ce:given-name>WP</ce:given-name></sb:author></sb:authors><sb:title><sb:maintitle>Carcinoma of the pancreas and periampullary region</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Ann 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Surg</sb:maintitle></sb:title><sb:volume-nr>122</sb:volume-nr></sb:series><sb:date>1987</sb:date></sb:issue><sb:pages><sb:first-page>827</sb:first-page><sb:last-page>829</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference></ce:bibliography-sec></ce:bibliography></tail></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Palliative operations for pancreatic carcinoma</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Palliative operations for pancreatic carcinoma</title></titleInfo><name type="personal"><namePart type="given">John R.</namePart><namePart type="family">Potts, III</namePart><namePart type="termsOfAddress">MD, FACS</namePart><affiliation>Ft. Lauderdale, Florida, USA</affiliation><affiliation>Requests for reprints should be addressed to John R. Potts III, MD, Department of General Surgery, Cleveland Clinic Florida, 3000 West Cypress Creek Road, Ft. Lauderdale, Florida 33309.</affiliation><affiliation>1From the Department of General Surgery, Cleveland Clinic Florida, Ft. Lauderdale, Florida, and the Department of General Surgery, Cleveland Clinic Foundation, Cleveland, Ohio.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Thomas A.</namePart><namePart type="family">Broughan</namePart><namePart type="termsOfAddress">MD, FACS</namePart><affiliation>Cleveland, Ohio, USA</affiliation><affiliation>1From the Department of General Surgery, Cleveland Clinic Florida, Ft. Lauderdale, Florida, and the Department of General Surgery, Cleveland Clinic Foundation, Cleveland, Ohio.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Robert E.</namePart><namePart type="family">Hermann</namePart><namePart type="termsOfAddress">MD, FACS</namePart><affiliation>Cleveland, Ohio, USA</affiliation><affiliation>1From the Department of General Surgery, Cleveland Clinic Florida, Ft. Lauderdale, Florida, and the Department of General Surgery, Cleveland Clinic Foundation, Cleveland, Ohio.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="Full-length article"></genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">1990</dateIssued><copyrightDate encoding="w3cdtf">1990</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">Controversies in palliation of pancreatic carcinoma include the best biliary bypass, the best gastric bypass, and how routinely gastric bypass should be used. We reviewed the records of 142 patients who underwent palliative operations for pancreatic carcinoma at the Cleveland Clinic over a 5-year period. Direct choledochal-enteric anastomosis proved superior to cholecystojejunostomy because of the high incidence of postoperative biliary sepsis and obstruction with the latter. The lowest incidence of these complications was achieved with choledochoduodenostomy. Loop gastrojejunostomy and Roux-Y gastrojejunostomy resulted in similar complication rates and postoperative stays, but, because loop reconstruction was simpler, it was deemed superior. Blood loss, operative time, and hospital stay were similar in patients with loop gastrojejunostomy and patients with no gastric bypass. This finding, coupled with a 10% incidence of subsequent gastric outlet obstruction in those without gastric bypass, indicates that gastric bypass should be liberally applied in the palliation of pancreatic carcinoma.</abstract><note>Presented at the 30th Annual Meeting of the Society for Surgery of the Alimentary Tract, Washington, D.C., May 16–17, 1989.</note><relatedItem type="host"><titleInfo><title>The American Journal of Surgery</title></titleInfo><titleInfo type="abbreviated"><title>AJS</title></titleInfo><name type="conference"><namePart>Papers of the Society for Surgery of the Alimentary Tract Presented at the 30th Annual Meeting, Washington, D.C.</namePart><namePart type="date">19890516</namePart><namePart type="date" encoding="w3cdtf">19890517</namePart></name><genre type="Journal">journal</genre><originInfo><dateIssued encoding="w3cdtf">199001</dateIssued></originInfo><identifier type="ISSN">0002-9610</identifier><identifier type="PII">S0002-9610(05)X8598-1</identifier><part><detail type="issue"><title>Papers of the Society for Surgery of the Alimentary Tract Presented at the 30th Annual Meeting, Washington, D.C.</title></detail><detail type="volume"><number>159</number><caption>vol.</caption></detail><detail type="issue"><number>1</number><caption>no.</caption></detail><extent unit="issue pages"><start>A2</start><end>A16</end></extent><extent unit="issue pages"><start>1</start><end>14</end></extent><extent unit="issue pages"><start>A18</start><end>A22</end></extent><extent unit="issue pages"><start>15</start><end>188</end></extent><extent unit="issue pages"><start>A23</start><end>A24</end></extent><extent unit="pages"><start>72</start><end>78</end></extent></part></relatedItem><identifier type="istex">A840F4F994C4E60E67E2407D8EC667D804C2FE8C</identifier><identifier type="DOI">10.1016/S0002-9610(05)80609-9</identifier><identifier type="PII">S0002-9610(05)80609-9</identifier><identifier type="ArticleID">05806099</identifier><accessCondition type="use and reproduction" contentType="">© 1990Reed Publishing USA</accessCondition><recordInfo><recordContentSource>ELSEVIER</recordContentSource><recordOrigin>Reed Publishing USA, ©1990</recordOrigin></recordInfo></mods></metadata><enrichments><istex:catWosTEI uri="https://api.istex.fr/document/A840F4F994C4E60E67E2407D8EC667D804C2FE8C/enrichments/catWos"><teiHeader><profileDesc><textClass><classCode scheme="WOS">SURGERY</classCode></textClass></profileDesc></teiHeader></istex:catWosTEI></enrichments><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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