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Original Research

RMJ. 2013; 38(2): 152-155


Validity of surgical bypass in unresectable pancreatic cancer

Arshad Malik, Abdul Razaque Shaikh, Gulshan Ara Shaikh.

Abstract
Background: A large number of patients with pancreatic cancer present late in the course of their disease when it is already beyond surgical cure. Palliation of the distressing symptoms like obstructive jaundice and gastric outlet obstruction becomes mandatory in most of the unresectable pancreatic tumors. This study is done to evaluate the efficacy of surgical bypass as a palliative procedure.
Methods: It’s a prospective descriptive analytical study conducted at a teaching hospital during the period from January 2005 to December 2010. All patients with obstructed jaundice and gastric outlet obstruction, later on diagnosed as pancreatic cancer are included in this study. Preliminary investigations included LFT’S, Blood CP, Ultrasound abdomen, CT scan abdomen, and x-ray chest. Surgical treatment was planned after assessing the resectability of the tumor based on a laid down criteria. Surgical bypass was done in patients with un-resectable tumors. The variables studied included demographic details, presentation, procedure performed, post operative complications, follow up after discharge from the hospital. The data is presented in percentages and ratios and is explained by tables and figures and Chi square test is applied wherever needed. The details of individual patients were collected on a proforma sheet and statistically analyzed on SPSS version 17.
Results: Forty three patients with a mean age of 62.09, Std 6.782, range 29, with advance carcinoma of head of pancreas were operated and bypass surgical palliation was done. The morbidity, mortality and efficacy of various surgical bypass operations are evaluated.
Conclusion: Bilio-gastric bypass still offers a reasonably safe and effective method of billiary decompression and duodenal obstruction caused by inoperable pancreatic cancer.

Key words: Pancreatic cancer, obstructive jaundice, bypass surgery.






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