Gastroenterology: Cancer of the bile duct — with bile duct obstruction — Endoscopic bougienage and stent implantation. Treatment
In the later stages of development, cholangiocarcinoma is often accompanied by the bile duct stenosis. Such a condition causes pain, jaundice and fever. If untreated, the abdominal abscess may be formed. To resume the flow of bile and prevent complications, the patient is prescribed the stent installation.
On the eve of the procedure, the physician conducts a clinical examination of the patient, reviews his/her case history and prescribes a set of required tests:
- complete and biochemical blood counts,
- blood test for tumor markers,
- abdominal ultrasound,
- CT/MRI scan of thorax and abdomen
- gastroscopy subject to sampling of samples for histological analysis,
Based on the findings, the professional decides on stenting.
The intervention is performed under local anesthesia. The physician inserts an endoscope (a flexible tube with a camcorder at the end) into the esophagus and subsequently into the stomach and duodenum through the mouth. The image from the camcorder is displayed on the monitor, which allows monitoring the course of surgery.
Having found a place where the common bile duct falls into the intestine lumen, the surgeon inserts the probe there and injects a radiopaque substance. With the help of X-ray, the specific duct blockage sites are revealed.
The narrowed sites are expanded by bougienage. After that, a stent is installed under the endoscopic control. The flexible tube allows restoring the duct patency and normalizing the flow of bile from the liver.
After surgery, the patients receive symptomatic therapy. His/her condition is monitored continuously by the medical staff. On day 9, if the patient feels good, s/he is discharged from the hospital and provided recommendations for further treatment.Hide
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