ENTEROBILIARY ANASTOMOSIS ΙΝ BEGNIGN AND MALIGNANT DISEASE OF PERIDUCTAL AREA

Abstract

Ιn our study (1980- 89) 237 petients were opereted for benignand malignant disease of the common bile duct, Vater's ampulla and pancreas. From these 87 patients underwent enterobiliary anastomosis. Ιn 54 patients we performed choledochoduodenal anastomosίs (28 common duct stones, 6 pencreatitis, 6 residual stones, 2 ruptured hepatic echinococcal cysts into common duct, 12 pencreatic Ca-). Ιn 17 petients we performed choledochojejunonal anastomosis (12 Ca- pancreatic head, 2 Ca-Vater's ampulla) and in 2 patients cholecystoduodenal anastomosis (2 Ca-pancreatic head). Operative mortality was 4,5% (4 deaths in 87). Improvement was determined according to degree of: pain relief decrease of bilirubin and alkaline phosphotase to normal levels and disappearance of septic phenomena. Such improvement was observed in 78% of patients (85% of choledochoduodenal anst., 64% of choledochojejunal anast. and 43% of cholocystojejunal anast .). Ιn 22% of the patients no improvement was observed. We conclude that choledochoduodenal and jejunal anastomosis are safe and effective. Choledochodyodenal is preffered for benign diseases and choledochojejunal for malignant. Cholocystojejunal are recommended for petients with extensive malignancy and high operative risk.