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World J Gastroenterol. Feb 7, 2006; 12(5): 765-767
Published online Feb 7, 2006. doi: 10.3748/wjg.v12.i5.765
Surgical treatment of patients with intermediate-terminal pancreatic cancer
Yu-Bin Liu, Liang Huang, Zhi-Yong Xian, Zhi-Xiang Jian, Jin-Rui Ou, Zi-Xian Liu
Yu-Bin Liu, Liang Huang, Zhi-Yong Xian, Zhi-Xiang Jian, Jin-Rui Ou, Zi-Xian Liu, Department of Hepatobiliary Surgery, Guangdong Provincial People’s Hospital, Guangzhou 510080, Guangdong Province, China
Supported by the Medical Science Technology Foundation of Guangdong Province, No. WSTJJ20021025210102701008182
Correspondence to: Dr Yu-Bin Liu, Department of Hepatobiliary Surgery, Guangdong Provincial People’s Hospital, Guangzhou 510080, Guangdong Province, China. benson_lau@hotmail.com
Telephone: +86-13826288388 Fax: +86-20-83827812-60920
Received: July 22, 2005
Revised: August 9, 2005
Accepted: August 15, 2005
Published online: February 7, 2006
Abstract

AIM: To investigate the surgical treatment of patients with intermediate–terminal pancreatic cancer.

METHODS: A retrospective analysis was made of the clinical data of 163 patients with intermediate–terminal pancreatic cancer who were surgically treated between August 1994 and August 2003.

RESULTS: A total of 149 patients underwent palliative surgery. The mortality rate of those who underwent cholecystojejunostomy alone was 14.2%, the icterus or cholangitis recurrence rate was 61.9% with an average survival period of 7.1 mo. The mortality rate for those who received hepatic duct-jejunostomy (HDJS) was 5.7%, the icterus or cholangitis recurrence rate was 6.8% with an average survival period of 7.1 mo. But 31.8% of the patients developed duodenum obstruction within 6 mo after the surgery, six of seven patients with severe pain were given peri-abdominal aorta injection with absolute alcohol and their pain was alleviated. The other patients underwent percutaneous transhepatic cholangial drainage (PTCD) and their icterus index returned to normal level within 40 d with an average survival period of 7.5 mo.

CONCLUSION: Roux-en-y HDJS combined with prophylactic gastrojejunostomy is recommended for patients with intermediate–terminal pancreatic cancer, and biliary prosthesis can partly relieve biliary obstruction in a short term.

Keywords: Pancreatic cancer, Bile duct conduction, Gastrointestinal conduction, Biliary prosthesis