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William B. Meinke, MD; Patrick L. Twomey, MD; James M. Guernsey, MD; Charles F. Frey, MD; George Higgins, MD; Robert Keehn, MS

Arch Surg. 1983;118(5):550-553.

Abstract
• Gastroenterostomy as part of the palliation of unresectable cancer of the head of the pancreas, in the absence of gastric outlet obstruction at the time of surgery, has been both rejected, and, more recently, advocated for all such patients. A study of 105 cases yielded four factors that correlated with the subsequent occurrence of gastric outlet obstruction: age, 60 years or younger; hemoglobin level, 11.5 g/dL or less; absence of liver metastases; and survival, three months or longer. A fifth factor, absence of clinical jaundice, may be an indicator of a poor prognosis with a small risk of obstruction. By combining factors, we identified a group with a risk of obstruction of at least 25% (those with two or more factors) and one with negligible risk.

(Arch Surg 1983;118:550-553)

Author Affiliations
From the Department of Surgery, Veterans Administration Medical Center, Martinez, Calif (Drs Meinke, Twomey, Guernsey, and Frey); the Department of Surgery, University of California at Davis, Sacramento (Drs Meinke, Twomey, Guernsey, and Frey); and the Surgical Service, Veterans Administration Medical Center (Dr Higgins) and the National Academy of Sciences (Mr Keehn), Washington, DC.

Footnotes
Accepted for publication Jan 3, 1983.

Read before the 90th annual meeting of the Western Surgical Association, Kansas City, Mo, Nov 15, 1982.

Reprint requests to Department of Surgery, 4301 X St, Room 257, Sacramento, CA 95817 (Dr Frey).

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