Segment III cholangiojejunostomy for palliation of malignant hilar obstruction

Between 1984 and 1992, 26 patients with obstructive jaundice due to malignancy at the liver hilum were treated by segment III Roux-en-Y cholangiojejunostomy. Twenty-two patients had hilar cholangiocarcinoma, one carcinoma of the gallbladder, one pancreatic carcinoma, one recurrent gastric carcinoma and one lymphoma. Seventeen patients had no complications in the postoperative period and six had complications; there were three postoperative deaths. Eighteen of the 23 surviving patients experienced complete resolution of jaundice for at least 3 months. Four developed recurrent jaundice and three had episodes of cholangitis before death. Segment III cholangiojejunostomy offers effective palliation for most patients with irresectable hilar malignancy.