Role of prophylactic gastroenterostomy for unresectable XXXX .

@entity1 @entity3123 @entity9727
Methods of palliation and the use of prophylactic gastroenterostomy in the treatment of unresectable @entity3123 remain controversial. Gastroenterostomy has been linked with various complications. We conducted a 10-year (1982-1992) retrospective review of @entity1 who had unresectable @entity3123 and underwent biliary decompression without prophylactic gastroenterostomy. 50 @entity1 were studied. Only four @entity1 (8%) developed @entity9727 and required reoperation for therapeutic gastroenterostomy. The mean time to obstruction was 15.75 months, whereas the mean overall survival was 12.99 months. The mean survival of @entity1 who underwent therapeutic gastroenterostomy was 32.25 months, with an average palliation of 16.5 months after the second operation. We conclude that @entity3123 has a rapid natural progression, and most @entity1 do not survive long enough to obstruct. The ones who do obstruct are unique in that they survive for a long period of time. We recommend that routine prophylactic gastroenterostomy is unnecessary, and selective use of gastroenterostomy should be exercised in case of present or impending @entity9727 .
