Laparoscopic cholecystojejunostomy: a technical application in unresectable biliary obstruction

Laparoscopic cholecystojejunostomy was accomplished utilizing an endoscopic gastrointestinal stapler in 2 patients with biliary obstruction and jaundice secondary to inoperable pancreatic carcinoma. This technique was performed on patients judged to be poor candidates for an open resection, due to medical conditions and associated comorbidities. The actual operating time, taking into account delays not related to the operation or technique, was 45-60 min. Both patients experienced immediate significant overall clinical improvement with minimal operative sequelae. The first patient was eating and ready for discharge in 4 days, and the second was prepared for discharge in less than 24 h. This operative procedure offers the patient excellent palliation with many advantages over traditional open surgery.