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Journal of Paediatric Surgeons of Bangladesh
Original Articles · Vol. 3 No. 1 (2012)

Short Term Outcome of Palliative Measures Taken for Clinically Labeled Unresectable Carcinoma Pancreas

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JPSB
Journal of
Paediatric Surgeons of Bangladesh
Published : January 2012
CONTENTSVolume 03Number 1January 2012
Editorial
Gastric Transposition in Long- Gap Esophageal Atresia
Md Abu Jafor
01
Review Articles
Spina Bifida and Hydrocephalus in children: Role of a Paediatric Surgeon
Md Tosadeque Hossain Siddiqui, Shoheli Alam, Zeba Ahmed
37
Original Articles
Bishop Koop Technique is Preferred than Primary Anastomosis in Managing Jejunoileal Atresia in a Setup without Neonatal Intensive Care Unit - Our Initial Experience
MA Mushfiqur Rahman, Md Abdullah Al Farooq, Md Akbar Husain Bhuiyan, Minhajuddin Sajid, Tanvir K Chowdhury, Golam Habib
05
Preputial Dartos Reinforced Snodgrass Tubularized Incised Plate Urethroplasties in Distal Hypospadias to Prevent Urethrocutaneous Fistula
Md Shah Alam Talukder, Debesh Ch Talukder, Md Abdullah Al Mahmud, Mohammed Showkot Ali, Nadiuzzaman Khan, Shankar Chandra Das, Sangul Islam, Md Shafiqul Bari
12
Short Term Outcome of Palliative Measures Taken for Clinically Labeled Unresectable Carcinoma Pancreas
Md Abdullah Al Farooq, MA Mushfiqur Rahman, Tania Tajreen, Mohammad Ali
18
An Audit of the Patients Treated in Paediatric Surgery Department of Ad-din Women’s Medical College Hospital, Dhaka
Musrat Rahman, Rezaul Islam, SM A Alim
26
Comparison between the Outcome of Tunica Vaginalis Blanket Wrap and Non-wrap Procedures in Urethroplasty
Mohammad Minhajuddin Sajid, Md Shahid Karim
30
Case Reports
Inflammatory Myofibroblastic Tumour in Antimesenteric Border of Descending Colon of Children: A Case Report
Shahnoor Islam, AKM Amirul Morshed, Afiqul Islam
47
Subcutaneous Emphysema: A Rare Postoperative Complication after Tonsillectomy
Manilal Aich Litu, Nurul Karim Chowdhury, Mohammad Amzad Hossain, Abdullah Al Mamun, Mashuque Mahmud, Dipali Bishwas, Utpal Kumar Dutta, Md Zahedul Alam
51
The Official Journal of the
ASSOCIATION OF PAEDIATRIC SURGEONS OF BANGLADESH (APSB)
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Authors

  • Md Abdullah Al FarooqAssistant professor, Department of Pediatric Surgery, Chittagong Medical College & Hospital, Chittagong
  • MA Mushfiqur RahmanAssistant Professor, Department of Pediatric Surgery, Chittagong Medical College & Hospital, Chittagong
  • Tania TajreenMedical officer, Medicine unit-III, Chittagong Medical College & Hospital, Chittagong
  • Mohammad AliProfessor & Head, Department of Hepato-Biliary-Pancreatic Surgery, BIRDEM Hospital, Shahbag, Dhaka

Keywords

Carcinoma pancreas Unresectable Palliative measure

Abstract

Background: At the time of diagnosis most of the pancreatic caner is well advanced and curative resection becomes impossible. These are labeled as unresectable carcinoma pancreas where only palliative medical or surgical measures could be done. Objectives: To observe the various types of palliations with their early result. Methods: This retrospective study was carried out in the department of Hepato-Biliary-Pancreatic Surgery in BIRDEM hospital, Dhaka, Bangladesh from July 2004 to June 2006. After careful check 50 patients were labeled as unresectable carcinoma pancreas. Surgical intervention was thought impossible in 10 patients and these patients took only chemotherapy. Laparotomy was carried out in the rest 40 patients with the plan to take open biopsy along with surgical palliation. Curative resection was seemed not to be possible in any patient. After abdominal exploration resectability of the pancreatic lesion was assessed and compared with prior plan. Post operative histopathology revealed pancreatic carcinoma in 35 patients. Postoperative treatment modalities used like chemotherapy, chemoradiation were assessed. Overall outcome of all the palliations were noted and compared with initial presentations. Result: Among 50 patients male were 28 (n₁) & female were 22 (n₂) with male female ratio was 1.27:1. Eighty percent (80%) patients presented between 51 to 70 years of age. Preoperative plan of surgical palliation noted to be changed significantly after laparotomy. Curative resections were possible in 2 patients. No palliative surgery was possible in 2 patients with gross disease and only biopsy was taken. Palliative surgeries along with biopsy were done in 36 patients. Only biliary bypass carried out in 04 patients, choledochojejunostomy with gastrojejunostomy were performed in 18 patients and hepatico- jejunostomy with gastrojejunostomy were performed in 12 patients. Only gastrojejunostomy were carried out in 02 patients to relieve duodenal obstruction. For pain control chemical splanchnicectomy done in 07 patients. There was no perioperative mortality. Early post operative complications were wound infection in 6 (15%) patients, haemorrhage in 2 (5%) patients and bilioenteric anastomotic leakage in 1 (2.5%) patient. Post operative histopathology reports revealed pancreatic carcinoma in 35 patients. After one year follow up it was noted that jaundice again developed in 02 patients (4.6%) underwent choledochojejunostomy and gastrojejunostomy. Control of pain was satisfactory in 31 patients (72.1%) by multimodal analgesia. Chemical splanchnicectomy was satisfactory in 4 (56%) patients to control pain. Twenty seven patients (54%) had died within a year. Only 16 (36%) patients were alive after one year. Seven patients (14%) had lost from follow up. Conclusion: Surgical palliation along with other medical palliations is recommended for unresectable carcinoma pancreas.

Journal of Paediatric Surgeons of Bangladesh (2012) Vol. 3 (1): 18–25

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