Single vs double bypass anastomosis for locally advanced periampullary tumors

Abstract

Background data Pancreatic adenocarcinoma is one of the most serious malignancies in the world. Endoscopic retrograde cholangiopancreatography is limited to cases of bile duct obstruction owing to its association with severe adverse effects and low efficacy. Surgical resection offers the greatest chance of long-term recovery by a procedure called pancreaticoduodenectomy. Palliative surgical options involve an open or laparoscopic loop over a Roux-en-Y gastrojejunostomy (GJ). Various studies have looked at the idea of prophylactic GJ. Patients and methods This is a comparative retrospective study, designed for patients having locally advanced periampullary tumors who were treated by palliative bypass (single or double bypass) between January 2011 and December 2016 at Gastrointestinal Surgery Center of Mansoura University. This study aims to evaluate and compare the results of single vs double bypass procedure. Full preoperative assessment was done. Results There was no statistically significant factor between the single and double bypass groups with respect to demographic data. With respect to postoperative data, the single bypass group showed its upper hand regarding the day of starting oral fluids. The amount discharge from the nasogastric tube was significantly higher for the double bypass group. The overall complications were more or less similar between the two groups. Conclusion This study showed that prophylactic GJ substantially reduces the incidence of gastric outlet obstruction and thus, decreases the rate of readmission and the need for another surgery after the single bypass. The overall complications as well as the short-term survival did not differ between single and double bypass operations.