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Stomach-interposed cholecystogastrojejunostomy: A palliative approach for periampullary carcinoma

World Journal of Gastroenterology 2005年第13期11卷 2009-2012页

作者： Chun-YiHao Xiang-QianSu Jia-FuJi Xin-FuHuang Bao-CaiXing DepartmentofSurgery PekingUniversitySchoolofOncologyBeijing100036China

AIM: For patients of periampullary carcinoma found to be unresectable at the time of laparotomy, surgical palliation is the primary choice of treatment. Satisfactory palliation to maximize the quality of life with low morbidity and mortality is the gold standard for a good *** aim is to explore such a procedure as an alternative to the traditional ***: A modified double-bypass procedure is performed by, in addition to the usual gastrojejunostomy,implanting a mushroom catheter from the gall bladder into the jejunum through the interposed stomach as an internal drainage. A retrospective review was performed including 22 patients with incurable periampullary carcinomas who underwent this ***: Both jaundice and impaired liver function improved significantly after surgery. No postoperative deaths, cholangitis, gastrojejunal, biliary anastomotic leaks, recurrent jaundice or late gastric outlet obstruction occurred. Delayed gastric emptying occurred in two patients. The total surgical time was 150±26 min. The estimated blood loss was 160±25 mL. The mean length of hospital stay after surgery was 22±6 d. The mean survival was 8 mo (range 1.5-18 mo).CONCLUSION: In patients of unresectable periampullary malignancies, stomach-interposed cholecystogastrojejunostomy is a safe, simple and efficient technique for palliation.

关键词： Palliation periampullary carcinoma Double by-pass

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Palliative surgical bypass for unresectable periampullary carcinoma

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Hepatobiliary & Pancreatic Diseases International 2008年第3期7卷 308-312页

作者： Shivendra Singh Ajay Kumar Sachdev Adarsh Chaudhary Anil Kumar Agarwal Department of Gastrointestinal Surgery Govind Ballabh Pant Hospital&Maulana Azad Medical CollegeNew Delhi 110002India

BACKGROUND:Around 60%to 80%of patients with periampullary carcinoma are unresectable either due to distant metastasis or local vascular *** the advancement of endoscopic interventional procedures,the role of surgical bypass has ***,surgical bypass is still appropriate in patients with unresectable disease discovered at the time of *** study was conducted to assess the results of palliative surgical bypass for patients with unresectable periampullary carcinoma at our hospital,a tertiary referral center of Northern India. METHOD:The study group comprised 204 patients who had undergone surgical bypass for advanced periampullary carcinoma over the last 15 years. RESULTS:Between January 1990 and December 2004,204 patients(128 males,76 females)consisting of 179 patients with carcinoma of head of the pancreas,14 patients with ampullary carcinoma,8 patients with lower end cholangiocarcinoma and 3 patients with duodenal carcinoma underwent surgical *** average age was 51 years (range 20-78 years).Both biliary and gastric bypasses were done in 158(77.45%),biliary bypass alone in 37(18.13%) and gastric bypass alone in 9(4.32%).Biliary bypass was done by Roux-en-Y hepaticojejunostomy,and gastric bypass by retrocolic *** overall postoperative mortality and morbidity were 0.98%and 26.9%,respectively The patients who died had undergone previously endoscopic *** included wound infection in 12.25%of the patients,bile leak in 5.12%,delayed gastric emptying in 5.38%,ascitic leak from drains in 8.8%,and upper gastrointestinal bleeding in 1.96%.The incidences of wound infection and bile leak both were significantly higher in patients who had had preoperative biliary stenting None of the patients who had undergone Roux-en-Y hepati cojejunostomy+retrocolic gastrojejunostomy required any intervention later in their ***:Surgical bypass is a safe procedure with negligible mortality and minimal mo

关键词： surgical bypass periampullary carcinoma

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CLINICAL ANALYSIS OF 150 PATIENTS WITH periampullary carcinoma

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Chinese Journal of Cancer Research 1995年第1期7卷 44-47页

作者：吴祥德宋振川耿翠芝李秉慧 Department of Surgery Fourth Hospital Hebei Medical College Shijiazhuang

This article report 150 cases of patients with periampullary carcinoma,of them,the tumors of 85 cases were in the head of pancreas,26 in lower part of the common bileduct,21 in ampulla of Vater and 18 in duodenal *** 150 patients,paucreatoduodenectomy were performed in 53 cases but one had total pancreactomy,with a total resection rate of 36%.respectability was high in ampulla and duodenal papilla cancers,with a resection rate of 89.5% and 83.3%,*** lowest resection rate 14.1%,was in patients with cancer in bead of the *** cases had postoperative complications,the morbidity rate was 13.3%.Postoperative death occurred in 9 cases with a mortality rate of 6%.The follow-up results showed that the 3-year and 5-year survival rates of the resection group were 31.8% and 11.8% ***-four cases with resec-tions had a mean survival period of 16.7 *** cartinoma group had the longest survival period,22.4 mouths,but non-resection group,all had bileinbestinal shunt only 4.8 mouths.

关键词： periampullary carcinoma Surgery Survival period.

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Clinical efficacy of total three-dimensional laparoscopic pancreatoduodenectomy

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Oncology and Translational Medicine 2016年第6期2卷 254-257页

作者： Wenbin Wang Zhongqiang Xing Haitao Lv Changqing Yan Jiansheng Zhang Tianyang Wang Jianhua Liu Department of Hepatobiliary Surgery The Second Hospital of Hebei Medical University

Objective To investigate the feasibility and clinical efficacy of total three-dimensional laparoscopic pancreatoduodenectomy. Methods The clinical data of 28 patients who underwent total three-dimensional laparoscopic pancreatoduodenectomy at the Second Hospital of Hebei Medical University from August 2015 to May 2016 were retrospectively analyzed. The surgical indications and method of performing total threedimensional laparoscopic pancreatoduodenectomy were similar to those of the patients who underwent two-dimensional laparoscopic pancreatoduodenectomy. All of the patients were followed up via outpatient reviews and telephone interviews through September 2016. Results In all 28 cases, total three-dimensional laparoscopic pancreatoduodenectomy was successfully performed with no conversion to laparotomy, intraoperative complications, or perioperative death. The mean operative time was 406 min(200–520 min) with a mean blood loss of 528 m L(200–1500 m L), a mean number of dissected lymph nodes of 11(6–16), a mean postoperative anus exhaust time of 4.4 d(2–8 d), and a mean length of stay of 16.9 d(9–23 d). There was a postoperative pancreatic fistula in 4 out of the 28 cases, with 3 cases of grade A and 1 case of grade B. Postoperatively, one patient with early-stage intra-abdominal hemorrhage improved after conservative symptomatic treatment, and two patients with gastroplegia were cured with conservative treatment. No complications occurred in the other patients. All of the cases underwent R0 resection with a negative surgical margin. All of the 28 patients were followed up for 6 to 12 months, with a median follow-up period of 9.2 months. During the follow-up period, there were no postoperative complications related to the procedures and no deaths; tumor recurrence was identified 9 months after the procedure using positron emission computed tomography(PECT) in one patient with pancreatic ductal *** Total three-dimensional laparoscopic pancreato

关键词： periampullary carcinoma laparoscopy pancreatoduodenectomy three-dimensional

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