Palliative surgery for pancreatic carcinoma

ABSTRACT

To evaluate the role of palliative surgical treatment in patients with advanced pancreatic carcinoma. Case series. Surgical [D] Ward of Khyber Teaching Hospital, Peshawar, from January 2005 to January 2009. The study included patients with pancreatic carcinoma admitted with advanced, unresectable carcinoma of the pancreas. Patients with resectable tumours and with previous history of gastric or biliary surgery were excluded. Palliative procedures were performed after assessment of the tumour and its confirmation as unresectable on ultrasound and CT scan +/- ERCP. Postoperatively all patients were referred to oncologist. Complications and mortality were noted. There were 40 patients, including 24 males and 16 females with mean age 58.72 +/- 6.42 years. The most common procedure performed was triple bypass in 21 [52.50%] patients followed by choledocho-, cholecysto-, hepatico- and gastro-jejunostomy in various combinations. Wound infection occurred in 7 patients and was more common in patients with co-morbidities. Biliary leakage occurred in 03 patients. Postoperative cholangitis occurred in 3 patients while 7 patients had minor leak from the drain site. Four patients developed UTI, while 5 patients had signs of delayed gastric emptying. Two patients had upper gastrointestinal bleeding. Three patients died due to septicemia and multiple organs failure. Rest of the patients were discharged in stable state. The mean hospital stay was 8.40 +/- 3.48 days and median survival was 7.72 +/- 2.39 months. Surgical palliation for the advanced carcinoma pancreas can improve the quality of life of patients and is associated with minimum morbidity and mortality