Alternative technique of laparoscopic hepaticojejunostomy for advanced pancreatic head cancer

Only 20% of patients with pancreatic cancer can undergo curative resection. Therefore. palliative treatment of pancreatic cancel assumes the utmost cl inical importance. The aim of the palliative treatment of pancreatic head c arcinoma is to relieve the jaundice and/or duodenal obstruction. Endoscopic or transparietal decompression of the obstructed bile duct can be accompli shed in most cases, but the durability of these techniques is not as great as that of a surgically created bypass. On the other hand, hepaticojejunost omy carries higher morbidity and mortality rates than the former nonsurgica l methods. In order to promote long lasting palliation with low morbidity a nd mortality rates, minimally invasive techniques of biliary and gastric by pass have been described. However, laparoscopic Roux-en-Y hepaticojejunosto my seems to be a complex surgical procedure. With an aim to simplify the co nstruction or a laparoscopic hepaticojejunostomy, the authors suggest an al ternative technique.