Prophylactic pylorus-preserving gastric transposition in unresectable carcinoma of the pancreatic head.

Patients with unresectable carcinoma of the pancreas head often present with intestinal obstruction during their disease, but the efficacy of a prophylactic gastrointestinal anastomosis is still under debate. Some investigators consider the population of patients who eventually develop this complication too small to justify the prophylactic use of this procedure. When done prophylactically, the gastrointestinal anastomosis tends not to function and close. Other surgeons have proposed supplementing the gastric bypass using technique alternatives. To demonstrate the low morbidity, the feasibility, and the advantages and disadvantages of this procedure, we report our personal experience with transection of the duodenum and re-establishment of the continuity of the alimentary tract with a duodenojejunal anastomosis performed in 34 patients.