Post-operative morbidity and complications were noted and compare with radical pancreato-duodenectomy and temporary bypass procedures done during the period of 1995 - 2004 at the department of heato - biliary-pancreatolgy at Cho Ray hospital Resultst: Fifteen patients (9 male and 6 female) with mean age of 67.8 y. o who were seriously sick with many concomitant illnesses (heart failure, pulmonary tuberculosis, hypertension, diabetes etc..) or those denying Whipple procedure, were attributed to duodenum opening and resection of the ampullary tumor followed by reconstruction of the choloedocho - pancreatic sphincter.