The Choice of Palliative Treatment for Biliary and Duodenal Obstruction in Patients With Unresectable Pancreatic Cancer: Is Surgery Bypass Better?

摘要

This study aimed to investigate the clinical significance of palliative operation for carcinoma of pancreas between bypass surgery and interventional therapy. Most patients with locally advanced pancreatic cancer cannot undergo resection and show obstructive jaundice at presentation. Methods of palliation in these patients comprise biliary stent or surgical bypass. We retrospectively analyzed the clinical data of 53 patients who underwent palliative treatment with incurable locally advanced pancreatic ductal adenocarcinoma. This retrospective study compared morbidity, mortality, hospital stay, readmission rate, and survival in these patients. A total of 31 patients underwent biliary bypass surgery, and 22 had interventional therapy. There was no significant difference in the patients' basic condition before operation and in the 30-day mortality between surgical palliation and intervention. However, there were some differences in the early complications, survival time, successful biliary drainage, and recurrent jaundice. Through analysis of these clinical data and the published studies, we conclude that surgical bypass is a better effective palliative method for patients than biliary and duodenum stent with locally advanced pancreatic cancer. Patients need to be carefully selected in consideration of operative risk and perceived overall survival.