THE ROLE OF PALLIATION IN PERIAMPULLAR CANCERS OF GERIATRIC AGE

Abstract

Authors wonder about the actual part of the palliative prac tices in periampullar cancers of the geriatric age, and the choice’s criteria of the different surgical options that are practicable. They reaffirm that the common radical opera tion is the pancreaticduodenectomy, even if, as it is veri fiable in the relevant literature and in our series of cases, it is practicable only a few times.

The necessity of amending the toxic-septic condition of the neoplastic colestasi, which certainly is more unfavourable during the geriatric age, gives to the palliative procedures a better rule, because few patients could be treated with a curative intention. Authors report their experience and their results about the icterus regression, mortality, morbility and the average survival rate.

About the surgical palliative options of the bilio-digestive shunts, they give the same importance to the gallblad derjejunostomy and to the common bile duct jejunostomy, granting to the first their preference in the geriatric age for the simplest and rapid execution. They point out the neces sity of the gastrojejunostomy in all the present or incipient jejuno’s obstruction, because of the surgical action’s impor tance, and to avoid another operation.

They give, even in the geriatric age, their preference to the surgical palliative treatments, proposing to reserve the endo scopic and radiologic practices to the patient undergoing an operation for the precarious general state, for the high ope rating risk and the modest residual life.

Infact, the non surgical treatments are suitable to amend the neoplastic colestasi, but they aren’t equivalent to the sur gical palliative, that is more effective for the greater survi vals, a better life’s quality, a smaller mortality and morbi lity