期刊
EJSO
卷 33, 期 6, 页码 757-762出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.ejso.2006.11.014
关键词
malignant biliary obstruction; biliary bypass; outcome; palliative care; periampullary carcinoma; pancreatic cancer; cholangiocarcinoma
Aims: This study aimed to analyse the current outcome after palliative surgical drainage of malignant biliary obstruction. Method: From 1992 to 2003, perioperative parameters and the incidence and indications of readmissions were analysed in 269 patients who underwent a palliative biliary bypass for periarrtpullary carcinoma. Results: Hospital mortality occurred in seven patients and median postoperative stay was 10 days. Anastomotic leakage occurred in three patients and intraabdominal haemorrhage in eight patients. Overall 75 patients experienced a complication. Nine patients underwent a relaparotomy during initial hospital admission. Overall, 142 patients were readmitted, 13 for indications related to the biliary bypass, 11 for surgery-related indications. Twenty-five patients were readmitted for radiochemotherapy, 112 for progressive disease and 23 for indications not related to the disease. Median survival was 7.5 months and the 3-year survival 3%. Survival was significantly lower in patients with metastases and in those who underwent elective bypass for gastric outlet obstruction. Conclusion: Current hospital mortality after palliative biliary bypass as well as readmission rates for complications related to the biliary bypass or surgical procedure are low. Surgical biliary bypass is a safe and effective palliative treatment for patients with malignant biliary obstruction. (c) 2006 Elsevier Ltd. All rights reserved.
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