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Peripheral hepatojejunostoy: a technic option for paliative treatment of hilar cancer

BACKGROUND: This study shows the experience of our service with peripheral hepatojejunostomy. METHODS: Between 2000 and 2005, eleven patients were submitted to peripheral hepatojejunostomy. Laparotomy in all patients had been performed as an attempt for curative resection. We analyzed age, gender, morbimortality, pre and post-operatory dosage of bilirubin, pre and post-operatory pruritus and survival. RESULTS: The mean age of the patients was 67 years, six were female and five were male. Jaundice was present in 100% of cases, and pruritus in 80%. Gallbladder neoplasm was diagnosed in six patients and cholangiocarcinoma in five. There were three intrahospital deaths. In preoperatory, mean values of total bilirubin was 19.33mg/dl and of direct bilirubin was 16.81mg/dl, and in the post-operatory, 4.88mg/dl and 3.64mg/dl, respectively. The eight discharged patients did not referred pruritus anymore, and their mean survival was eight months. All patients evoluted without jaundice and pruritus. CONCLUSIONS: Peripheral Hepatojejunostomy can be considered as capable to improve quality of life of the icteric patients. Surgery was demonstrated to be safe, with minimal blooding, rapid execution, and acceptable mortality rates. It was possible to improve significatively jaundice, pruritus, and to give a satisfactory survival.

Liver; Liver neoplasms; Palliative care


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