1. Surgical palliation in
Peri ampullary
carcinoma
Dr.Mukunda N.K.
Surgical gastro clinics

2. Symptoms palliated
Jaundice
Duodenal obstruction
Pain

3. Approach
Open
Laparoscopic
Both are equal in efficacy
No one is superior over other

4. Jaundice
Unresectable pre op
when life expectancy is >6 months
Unresectable intra op
Choledocho jejunostomy
Preferred to cholecysto jejunostomy
Metastatic
No role

5. Duodenal obstruction
Unresectable pre op
Unresectable intra op
Metastatic
Treatment of choice if the patient is fit

6. Pain
Unresectable pre op
No role
Unresectable intra op
50% alcohol
Metastatic
No role