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Modified Devine exclusion for unresectable pancreatic head carcinoma
1Department of Surgery, Hokkaido Gastroenterological Hospital, Honcho 1-1, Higashiku, Sapporo, 065-0041, Japan.
Hepato-Gastroenterology
|May 31, 2001
Summary
Modified Devine exclusion offers improved outcomes for unresectable pancreatic head carcinoma compared to conventional gastrojejunostomy. This technique enhances oral intake and discharge rates, providing a more effective bypass for patients.
Area of Science:
- Surgical Oncology
- Gastroenterology
- Palliative Care
Background:
- Gastrojejunostomy is a standard procedure for unresectable pancreatic head carcinoma.
- Conventional gastrojejunostomy bypasses may have limited effectiveness.
Purpose of the Study:
- To compare the efficacy of modified Devine exclusion versus conventional gastrojejunostomy.
- To evaluate outcomes in patients with unresectable pancreatic head carcinoma and duodenal stenosis.
Main Methods:
- A comparative study involving 5 cases of conventional gastrojejunostomy and 7 cases of modified Devine exclusion.
- Patients had unresectable pancreatic head carcinoma with severe duodenal stenosis.
- Outcomes assessed included operation time, oral intake, hospital stay, discharge rates, survival, and complications.
Main Results:
- No significant differences in operation time, time to oral ingestion, or hospital stay.
- Modified Devine exclusion showed significantly better discharge rates (P = 0.028).
- Modified Devine exclusion demonstrated improved peroral ingestion and longer 50%-survival periods (159 days vs. 65 days), with no tumor bleeding complications.
Conclusions:
- Modified Devine exclusion is a simple and effective surgical technique.
- It offers superior outcomes for managing unresectable pancreatic head carcinoma with duodenal obstruction.