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June 1996

Antrectomy: A Safe and Effective Bypass for Unresectable Pancreatic Cancer

Author Affiliations

Clermont-Ferrand, France

Arch Surg. 1996;131(6):676. doi:10.1001/archsurg.1996.01430180102024

We read with interest the article entitled "Antrectomy: A Safe and Effective Bypass for Unresectable Pancreatic Cancer" by Lucas et al.1 As they stated, the main disadvantages of antrectomy are prolongation of the procedure and the difficulty in performing antrectomy in some cases. We advocate performing an antral exclusion to simplify the procedure.2 The aim of antral exclusion (as for antrectomy) is to avoid the effects of antral malfunction on gastric emptying and the duodenal "circulus vitiosus." Antral exclusion is performed by means of a linear stapling device, ie, the 4-row TA90 (Auto Suture, Elancourt, France). The device is fired without dividing any gastric vessel. Then, a retrocolic side-to-side gastrojejunostomy is performed close and proximal to the linear row. This procedure is easier to perform and consumes less time than antrectomy. To date, this procedure has been performed in 8 patients. The postoperative course was uneventful in all

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