LA COLANGIODIGIUNOSTOMIA SUL DOTTO DEL TERZO SEGMENTO EPATICO SECONDO SOUPAULT E COUINAUD NEL TRATTAMENTO DELLE STENOSI NEOPLASTICHE NON RESECABILI DEL CONFLUENTE BILIARE

Palliative management choice of neoplastic stenosis. at biliary carrefour is based more on evaluation of the patient's general condition than simple considerations about morbidity and mortality associated with the different technique used. The decision between a surgical or not surgical procedure should be guided to obtain best palliation in terms of quality of life. A series of nine patients affected by non resectable hilar cancer, still in good general condition, underwent operation to achieve a valid biliry drain through a biliary-jejunostomy on third intrahepatic duct segment. Our results are not only comparable to other surgical series reported in literature but also to data of non surgical ones and respect of the latter we obtained nevertheless a best comfort index. So, we consider biliodigestive anastomosis according to Couinaud and Soupault as palliative procedure of choice for non resectable cancer of biliary carrefour.