Palliative operations for pancreatic carcinoma
Identifieur interne : 003399 ( Main/Exploration ); précédent : 003398; suivant : 003400Palliative operations for pancreatic carcinoma
Auteurs : John R. Potts Iii [États-Unis] ; Thomas A. Broughan [États-Unis] ; Robert E. Hermann [États-Unis]Source :
- 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.
Url:
DOI: 10.1016/S0002-9610(05)80609-9
Affiliations:
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Potts Iii</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Ft. Lauderdale, Florida</wicri:regionArea><placeName><region type="state">Floride</region></placeName></affiliation><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Floride</region></placeName><wicri:cityArea>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</wicri:cityArea></affiliation><affiliation><wicri:noCountry code="subField">Ohio.</wicri:noCountry></affiliation></author><author><name sortKey="Broughan, Thomas A" sort="Broughan, Thomas A" uniqKey="Broughan T" first="Thomas A." last="Broughan">Thomas A. 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Hermann</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Cleveland, Ohio</wicri:regionArea><placeName><region type="state">Ohio</region></placeName></affiliation><affiliation><wicri:noCountry code="subField">Ohio.</wicri:noCountry></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><affiliations><list><country><li>États-Unis</li></country><region><li>Floride</li><li>Ohio</li></region></list><tree><country name="États-Unis"><region name="Floride"><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></region><name sortKey="Broughan, Thomas A" sort="Broughan, Thomas A" uniqKey="Broughan T" first="Thomas A." last="Broughan">Thomas A. Broughan</name><name sortKey="Hermann, Robert E" sort="Hermann, Robert E" uniqKey="Hermann R" first="Robert E." last="Hermann">Robert E. Hermann</name><name sortKey="Potts Iii, John R" sort="Potts Iii, John R" uniqKey="Potts Iii J" first="John R." last="Potts Iii">John R. 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