[Palliative treatment of cancers of the head of the pancreas. Surgery versus endoscopy].

Cancers of the head of the pancreas are only resectable in 10 to 25% of cases. The majority of patients are therefore candidates for a palliative treatment jaundice, pain or upper gastro-intestinal obstruction. Palliative surgical bypasses offer a durable efficiency for patients with a relatively short-term life expectancy. Endoscopic placement of biliary stents for jaundice is an alternative but leads to frequent complications and does not act on other clinical symptoms. Controlled trials did not show any statistical difference between surgical or endoscopic treatments. We only recommend endoscopic procedures for patients unfit for surgery with poor general status or distant metastases.