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Table of Contents
Vol. 5, No. 4-5, 2005
Issue release date: August 2005
Section title: Review
Pancreatology 2005;5:325–329

Current Status of Laparoscopic Biliary Bypass in the Management of Non-Resectable Peri-Ampullary Cancer

Date R.S. · Siriwardena A.K.
Hepatobiliary Unit, Department of Surgery, Manchester Royal Infirmary, Manchester, UK
email Corresponding Author

A.K. Siriwardena, MD, FRCS

HPB Unit, Department of Surgery

Manchester Royal Infirmary, Oxford Road

Manchester M13 9WL (UK)

Tel. +44 161 276 4250, Fax +44 161 276 4530, E-Mail ajith.siriwardena@cmmc.nhs.uk

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Background: In patients with non-resectable peri-ampullary cancer, optimization of quality of life is an important goal. Although endoscopic palliation is widely used, the proponents of laparoscopic biliary bypass claim that this procedure alters management towards surgery. However, the evidence base for selection of laparoscopic bypass is limited and the aim of this report is to scrutinize the available evidence in order to assess the current role of this procedure. Methods: A computerised literature search was made of the Medline database for the period from January 1966 to December 2004. Searches identified 12 reports of laparoscopic palliation for peri-ampullary cancer. These reports were retrieved and data analysed in the following categories: type of bypass; combination with other procedures; complication and outcome. Results: Laparoscopic cholecystoenterostomy is the commonest form of laparoscopic biliary bypass practiced. Of the 52 reported cases undergoing laparoscopic biliary bypass, 40 underwent laparoscopic cholecystojejunostomy, 6 laparoscopic choledochoduodenostomy and 6 underwent laparoscopic hepaticoje- junostomy. Conclusion: Current evidence does not justify the incorporation of laparoscopic biliary bypass techniques into contemporary evidence-based management algorithms for patients with non-resectable periampullary cancer.

© 2005 S. Karger AG, Basel and IAP

Article / Publication Details

First-Page Preview
Abstract of Review

Published online: June 23, 2005
Issue release date: August 2005

Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 3

ISSN: 1424-3903 (Print)
eISSN: 1424-3911 (Online)

For additional information: http://www.karger.com/PAN

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