of % Patients Whipple's resection 16 42% Distal Pancreatectomy 2 5.2% Palliative HJ 3 7.8% Triple bypass 3 7.8% Cholecystojejunostomy
1 2.6% Cholecystojejunostomy
+ 1 2.6% Gastrojejunostomy Gastrojejunostomy 1 2.6% Day of Enteral No.
In the first operation, Kausch performed a cholecystojejunostomy
and a side-to-side enterostomy.
Choledochojejunostomy is preferred method for bilio-pancreatic malignancy8,13 because majority of cases are not curable and present with obstructive jaundice6 thus most commonly performed method is cholecystojejunostomy
for irresectable pancreatic carcinoma14 along with routine gastrojejunostomy.15 In this study different variants of choledochojejunostomy in the form of side to side choledochojejunostomy (6.02%), side to side choledochojejunostomy with enter-enterostomy (6.02%) and Roux-en-Y choledochojejunostomy (12.05%) were performed mainly for benign conditions such as biliary strictures, biliary obstruction of unknown aetiology and biliary injuries.
The 4 patients with carcinoma of the head of the pancreas had a loop cholecystojejunostomy
One patient with palliative cholecystojejunostomy with jejunojejunostomy again for Ca Head of Pancreas died on the 15th postoperative day due to sepsis; 3 cases that underwent Whipple's procedure for Carcinoma Ampulla of Vater during his followup was asymptomatic except for delayed gastric emptying which was treated with prokinetic drugs.
Palliative cholecystojejunostomy for obstructive jaundice in patients who have tumours, which are not resectable have also shown to decrease the direct bilirubin sizably at the rate of approximately 1.2 mg/dL/day.
For malignancy operative curative procedure was Whipple's surgery and palliative procedure was cholecystojejunostomy.
(2) Previously surgical biliary bypass operation such as cholecystojejunostomy
or choledochojejunostomy was the treatment for relief of obstructive jaundice in unresectable malignancy.