Abstract
Bypass operations for unresectable pancreatic head cancer were classified into 3 groups: biliary bypass group (42 cases), gastointestinal bypass 912), and double bypass (16), and compared for postoperative courses and complications. In biliary bypass group, postoperative duodenal stenosis and gastrointestinal bleeding were found in each 6 cases (14.3%). In gastrointestinal bypass group, jaundice was found postoperatively in only one case. In double bypass group, cholangitis was associated in 5 cases (33%) with single tract reconstruction, while the anastomotic stenosis, in only one case (16%) with double tract reconstruction. Because oral intake and hospital stay were nearly identical in each group, the additional gastrointestinal bypass operation was considered not to be the major surgical stress for the patient. Double bypass operation should be recommended. Reconstruction with double tract might be superior to the other in preventing postoperative cholangitis and gastrointestinal bleeding.
