Double Bypass Versus Stent-treatment in Irresectable Pancreatic Cancer

Double Bypass vs Stent Strategy in Peroperatively Diagnosed Irresectable Pancreatic Cancer - A Prospective Randomized Multicenter Study

Double bypass (hepaticojejunostomy + gastrojejunostomy) is compared to stent strategy in patients planned for curative pancreatic resection in whom peroperative findings makes resection impossible.

Inclusion Criteria:

1. Preoperatively

   • Patients with stent treated tumor in the pancreatic head or periampullary planned for pancreaticoduodenectomy
   • The patient jaundice should have worn off and there should be no signs of duodenal obstruction
   • The patient has given informed consent after verbal and written information in accordance with approved ethics application
   • The patient has no anatomical conditions making endoscopic therapy impossible such as previous Billroth II or Gastric Bypass.

2. Intraoperatively

   • Peroperative findings of of carcinomatosis, metastases or local irresectability who oppose radical surgery
   • Surgical double bypass should be technically feasible
   • The patient has given informed consent after verbal and written information in accordance with approved ethics application

Exclusion Criteria:

• Peroperative signs of dysfunction on biliary stent
• Peroperative findings of gastric outlet obstruction
• Surgical double bypass not technically feasible