A number of articles in the 1970's showed the higher rate of stricture of parallel side-to-side anastomoses of jejunum to CBD, presumably because the stoma tends to collapse on itself and grow together--by putting the two longitudinal incisions in the jejunum and CBD perpendicular to each other, sewing the middle of the jejunal incision to the superior corner of the CBD incision, etc (just like I would hope we all do in a duodenum to CBD anastomosis, and similar to how we sew a Heinecke-Mikulicz pyloroplasty), the stoma is forced to remain open, and the studies show this to be true in a virtually 0 incidence of stricture. I don't have these studies handy, but this is described in Fromm's text on GI surgery, and I will look them up for your information--it's not often I get to educate you! But another point--in one sentence you admit no knowledge of long-term outcome for C-J anastomosis in benign disease, but then inexplicably call it inferior--how do you justify this?
In fact, I try to avoid C-J anastomosis as much as I can, but this has nothing to do with its natural history (which I maintain is as good as any other CBD- enteric anastomosis--cancer also tends to stricture CBD-duodenum anastomoses) but with the extra time and suture lines required to construct it, and I just find it to be more awkward to perform.
I also disagree with those recommending pancreatic resection in this setting--first bypass the demonstrated CBD obstruction, which is much simpler for surgeon and patient, because that will likely take care of the problem and save those patients a life-threatening procedure. If chronic pain continues, and the pancreatic duct is dilated, a Puestow pancreato-jejunostomy is the procedure of choice, with a high likelihood of success, and a much nicer procedure than Child's pancreatic resection (yekk!) I would honestly like to know if those recommending the latter still really do that outmoded surgery, or if your just parroting your interpretation of some outdated textbooks? My impression is that that procedure is no longer indicated, in view of it's high mortality/morbidity for such small if any gain.