Journal article
Palliative decompression of obstructive hilar malignancies utilizing an extrahilar biliary approach
Digestive diseases and sciences, Vol.45(8), pp.1585-1593
2000
DOI: 10.1023/A:1005569128877
PMID: 11007110
Abstract
Hilar cancers carry a dismal prognosis. Palliation of obstructive jaundice in patients with hilar cancer can be achieved by either surgical or nonsurgical means. Selection of the appropriate palliative measures is a challenging problem. Segmental bilioenteric anastomosis procedures were performed on 19 patients with hilar cancer. Seventeen of the bypasses were done to the segment III duct, known as the ligamentum teres approach, and two bypasses were to the segment V duct. Five patients, who had already been stented percutaneously or endoscopically, were operated on after the stents were clogged and a duodenal obstruction ensued. There were two postoperative deaths (10.5%) and four postoperative complications (21%). All of the 17 surviving patients experienced improvement in the level of jaundice postoperatively and the levels of serum total and direct bilirubin decreased by 78.9% and 84.2%, respectively. Two patients developed late cholangitis before death and were treated by external biliary drainage; one developed duodenal obstruction and was treated by gastrointestinal anastomosis. The mean length of hospital Stay was 15.2 days. Mean survival was 8.2 months and the mean period of well-being was 7.8 months. Median survival was 7 months and median period of well being was 7 months. Three patients are still alive at 8, 8, and 24 months. These data suggest that the ligamentum teres approach offers effective palliation for patients with unresectable hilar cancer.
Details
- Title: Subtitle
- Palliative decompression of obstructive hilar malignancies utilizing an extrahilar biliary approach
- Creators
- Sezai Yilmaz - Inonu UniversityVedat Kirimlioglu - Inonu UniversityDaniel A Katz - Inonu UniversityMehmet Caglikulekci - Inonu UniversityMehmet Yilmaz - Inonu University
- Resource Type
- Journal article
- Publication Details
- Digestive diseases and sciences, Vol.45(8), pp.1585-1593
- Publisher
- Springer
- DOI
- 10.1023/A:1005569128877
- PMID
- 11007110
- ISSN
- 0163-2116
- eISSN
- 1573-2568
- Language
- English
- Date published
- 2000
- Academic Unit
- Surgery
- Record Identifier
- 9984322810902771
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