A rapid technique for biliary and duodenal bypass in nonresectable pancreatic carcinoma

A technique for biliary and duodenal bypass in patients with metastatic or locally nonresectable pancreatic carcinoma was used in 18 patients. Biliary tract decompression was achieved with a Roux-en-Y cholecystojejunostomy and duodenal bypass with a gastrojejunostomy using an automated stapling device. Although all patients eventually die of this disease, there was no operative mortality and no evidence of anastomotic leak, bleed, or stricture formation in the present series. This procedure reduces the operative time required to perform these anastomoses in poor-risk cases.