Article Text

Peripheral hepatojejunostomy: a last resort palliative solution in Greece during the economic crisis
  1. Georgios C Sotiropoulos1,
  2. Eleftherios Spartalis2,
  3. Nikolaos Machairas1,
  4. Gregory Kouraklis1
  1. 12nd Department of Propaedeutic Surgery, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
  2. 22nd Department of Propaedeutic Surgery, ‘Laikon’ Hospital, University of Athens Medical School, Athens, Greece
  1. Correspondence to Dr Georgios C Sotiropoulos, georgios.sotiropoulos{at}


The geographical distribution of Greece and the growing proportion of uninsured patients make imperative the need for effective and efficient palliative solutions regarding obstructive jaundice due to hepatic malignancy, while repeated endoscopic interventions and all associated materials are either not accessible to the whole population or not even available on a daily basis due to the economic crisis and the difficulties on the hospital supply. On this basis, palliative hepatojejunostomy, introduced more than 50 years ago, could be revisited in the Greek reality in very selected cases and under these special circumstances. We report on two patients with locally advanced hilar cholangiocarcinoma and intrahepatic cholangiocarcinoma, respectively, who were treated with a combination of double hepaticojejunostomy with peripheral hepatojejunostomy or peripheral hepatoejunostomy alone, respectively. Both patients experienced an adequate decompression of the biliary tract over more than a year. Palliative hepatojejunostomy could be an ultimate solution for selected patients and circumstances in Greece during the economic crisis.

  • hepatic cancer
  • palliative procedures
  • health economics
  • general surgery

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  • Contributors GCS and ES collected the data and wrote the paper; ES and NM performed the data analysis; GCS and GK designed the paper; NM and GK performed the drafting of the article, NM and GK revised critically the paper. All authors have substantial contribution to the study design, the acquisition and analysis of data, the revision of the paper and have approved the final version of it.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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