Biliary bypass for ductal adenocarcinoma of the pancreas: Mayo Clinic experience, 1970-1975.

During a recent 6-year period at the Mayo Clinic, 151 biliary bypass procedures for ductal adenocarcinoma of the pancreas were done, with operative mortality of 6.0% and an acceptable operative morbidity. Relief of jaundice was universal among survivors. Median survival was 6.0 months, and 3-year survival was 2%. These figures are compared with those for resective procedures.

Gracilis myocutaneous vaginal reconstruction.

Pelvic exenteration or extensive abdominoperineal resections, in combination with radiation therapy, may result in difficulties with healing of the wound in the perineum. In addition, the reconstruction of a functional vagina is rendered difficult. At the Mayo Clinic between February 1980 and October 1981, eight patients underwent vaginal reconstruction with use of bilateral gracilis myocutaneous flaps. Although complications were experienced, the procedure resulted in healed wounds in all patients. Patient satisfaction with respect to sexual function was variable. Reconstruction of the vagina and closure of the extensive defect after pelvic exenteration by using gracilis myocutaneous flaps seems to be a worthwhile and appropriate procedure.

Simultaneous bilateral staged groin flaps for coverage of mutilating injuries of the hand.

In the massively injured hand when both volar and dorsal surfaces are traumatized, the options for coverage are limited. Simultaneous bilateral groin flaps have been used in 2 patients for reconstruction of soft tissue defects with acceptable results. This is a reliable method of cover that is easily performed with minimal donor site morbidity.