Palliative Bilio-Digestive Anastomosis for the Treatment of Bile Duct Obstruction Due to Pancreatic Head Tumors: Techniques and Therapeutic Results

Abstract

Introduction: Biliary-digestive anastomosis are a fistulization between the bile ducts and the digestive tract that aims at permanent drainage of bile to the digestive tract in case of obstruction at the lower bile duct. The objective of our study was to describe the main techniques and postoperative results of biliary-digestive anastomoses in the treatment of pancreatic head tumors in the visceral surgery department of the Donka national hospital. Material and Methods: This is a descriptive cross-sectional study for 5 years duration from January 01, 2014 to December 31, 2019 which focused on the records of patients who underwent bilio-digestive anastomosis for pancreatic head tumors. Results: The frequency of biliary-digestive anastomosis was 0.38% (N=24). The mean age was 43.75 years with a male predominance of 54.17% (n=13): sex ratio 1.18. The clinical picture was dominated by jaundice, dark urine and stool discoloration in all cases. Abdominal Computed Tomographic (CT) scan and Ultrasound (US) were the reference examinations. The indications were tumors of the head of the pancreas 100% (n=24). The approach was median supra-umbilical in all cases. The types of anastomosis were dominated by choledochodenal anastomosis 54.16% (n=13) followed by cholecysto-jejunal 20.83% (n=5) and choledoco-