Brief Reports
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 7, 2005; 11(13): 2009-2012
Published online Apr 7, 2005. doi: 10.3748/wjg.v11.i13.2009
Stomach-interposed cholecystogastrojejunostomy: A palliative approach for periampullary carcinoma
Chun-Yi Hao, Xiang-Qian Su, Jia-Fu Ji, Xin-Fu Huang, Bao-Cai Xing
Chun-Yi Hao, Xiang-Qian Su, Jia-Fu Ji, Xin-Fu Huang, Bao-Cai Xing, Department of Surgery, Peking University School of Oncology, Beijing 100036, China
Author contributions: All authors contributed equally to the work.
Correspondence to: Chun-Yi Hao, MD., Department of Surgery, Peking University School of Oncology, 52 Fu-Cheng-Lu Street, Beijing 100036, China. haochunyi@vip.sina.com
Telephone: +86-10-88121122 Fax: +86-10-88122437
Received: November 25, 2004
Revised: November 26, 2004
Accepted: December 21, 2004
Published online: April 7, 2005
Abstract

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 procedure. Our aim is to explore such a procedure as an alternative to the traditional ones.

METHODS: 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 surgery.

RESULTS: 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 cholecystogastr-ojejunostomy is a safe, simple and efficient technique for palliation.

Keywords: Palliation; Periampullary carcinoma; Double by-pass