PALLIATIVE BYPASS SURGERY IN CARCINOMA OF THE HEAD OF THE PANCREAS

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Abstract
A review of 52 patients having palliative bypass surgery for carcinoma of the head of the pancreas revealed that 20% of patients required subsequent laparotomy for relief of gastric outlet obstruction and that biliary-enteric anastomoses using the gallbladder were unsatisfactory in 25% of patients. Gastro-enterostomy should be performed routinely during the initial laparotomy. The biliary anatomy should be demonstrated by pre-operative or intraoperative contrast X-rays and the gallbladder should be used for biliary-enteric anastomosis only when it is certain that the biliary system will be adequately drained.