@article{10.11648/j.js.20221001.17,
  author = {Mamadou Traore and Bernadette Ahou N’Dri and Ibrahim Kouakou Anzoua and Bernadin Kouame Kouakou and Ismael Kalou Leh Bi and Amos Serge Ekra and Amos Blaise Kouakou and Alassane Binate and Venance Alloka and Inza Bamba and Ezechiel Akowendo and Roger Lebeau and Bamourou Diane},
  title = {Palliative Surgery in Pancreatic Head Cancer at the University Hospital of Bouaké},
  journal = {Journal of Surgery},
  volume = {10},
  number = {1},
  pages = {34-39},
  doi = {10.11648/j.js.20221001.17},
  url = {https://doi.org/10.11648/j.js.20221001.17},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20221001.17},
  abstract = {Introduction: Cancer of the head of the pancreas is increasing in incidence. It represents 3% of all cancers and 20% of digestive cancers. Diagnosis is most often late. Indeed, 80% of these cancers are discovered at an advanced stage. In this case, the treatment is essentially palliative. The reference treatment is chemotherapy associated with endoscopic treatment if there is obstruction of the bile duct. Palliative surgery is only indicated in the case of intraoperative discovery of a contraindication to a curative surgical procedure. However, this palliative surgery is still in the forefront in low-income countries with limited technical facilities. The aim of this work was to determine the frequency and modalities of palliative surgery in unresectable pancreatic head cancer and to evaluate the results. Methods: Retrospective and descriptive study of the files of patients who underwent palliative surgery for a malignant tumour of the head of the pancreas; operated at the University Hospital of Bouake from January 2011 to December 2020. Results: Palliative surgery was performed in 71 patients, or 80.6% of patients with locally advanced pancreatic head tumour. We performed a double biliary and digestive bypass systematically. The digestive bypass was a gastrojejunal anastomosis in all cases. For the biliary-digestive diversion, different modalities were performed, notably a choledocho-jejunal anastomosis in 53.6% (n=38), a cholecysto-jejunal anastomosis in 38.0% (n=27) and a choledochodenal anastomosis in 8.4% (n=6). The overall morbidity was 22.5% (n=16). Morbidity related to the surgical procedure was 18.3% (n=13). These were biliary leakage (n=6; 8.4%) and parietal bleeding (n=4; 5.6%). Three patients died immediately postoperatively, giving an operative mortality of 4.2%. The mean survival of the patients was 5.8±2.2 months. Conclusion: Palliative surgery occupies a privileged place in our practice, allowing an improvement in the quality of life of the patients without apparent influence on the long-term prognosis which remains appalling. The hope of improving the prognosis lies in early diagnosis and strengthening the technical platform.},
 year = {2022}
}

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TY  - JOUR
T1  - Palliative Surgery in Pancreatic Head Cancer at the University Hospital of Bouaké
AU  - Mamadou Traore
AU  - Bernadette Ahou N’Dri
AU  - Ibrahim Kouakou Anzoua
AU  - Bernadin Kouame Kouakou
AU  - Ismael Kalou Leh Bi
AU  - Amos Serge Ekra
AU  - Amos Blaise Kouakou
AU  - Alassane Binate
AU  - Venance Alloka
AU  - Inza Bamba
AU  - Ezechiel Akowendo
AU  - Roger Lebeau
AU  - Bamourou Diane
Y1  - 2022/02/16
PY  - 2022
N1  - https://doi.org/10.11648/j.js.20221001.17
DO  - 10.11648/j.js.20221001.17
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 34
EP  - 39
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20221001.17
AB  - Introduction: Cancer of the head of the pancreas is increasing in incidence. It represents 3% of all cancers and 20% of digestive cancers. Diagnosis is most often late. Indeed, 80% of these cancers are discovered at an advanced stage. In this case, the treatment is essentially palliative. The reference treatment is chemotherapy associated with endoscopic treatment if there is obstruction of the bile duct. Palliative surgery is only indicated in the case of intraoperative discovery of a contraindication to a curative surgical procedure. However, this palliative surgery is still in the forefront in low-income countries with limited technical facilities. The aim of this work was to determine the frequency and modalities of palliative surgery in unresectable pancreatic head cancer and to evaluate the results. Methods: Retrospective and descriptive study of the files of patients who underwent palliative surgery for a malignant tumour of the head of the pancreas; operated at the University Hospital of Bouake from January 2011 to December 2020. Results: Palliative surgery was performed in 71 patients, or 80.6% of patients with locally advanced pancreatic head tumour. We performed a double biliary and digestive bypass systematically. The digestive bypass was a gastrojejunal anastomosis in all cases. For the biliary-digestive diversion, different modalities were performed, notably a choledocho-jejunal anastomosis in 53.6% (n=38), a cholecysto-jejunal anastomosis in 38.0% (n=27) and a choledochodenal anastomosis in 8.4% (n=6). The overall morbidity was 22.5% (n=16). Morbidity related to the surgical procedure was 18.3% (n=13). These were biliary leakage (n=6; 8.4%) and parietal bleeding (n=4; 5.6%). Three patients died immediately postoperatively, giving an operative mortality of 4.2%. The mean survival of the patients was 5.8±2.2 months. Conclusion: Palliative surgery occupies a privileged place in our practice, allowing an improvement in the quality of life of the patients without apparent influence on the long-term prognosis which remains appalling. The hope of improving the prognosis lies in early diagnosis and strengthening the technical platform.
VL  - 10
IS  - 1
ER  - 

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