Gastroenterology: Pancreatic cancer — with stenosis — Ercp and bougienage with stenting. Treatment
In recent years, pancreatic cancer is ahead of the other cancers by incidence. The first symptoms of disease appear relatively late and, as a rule, when the tumor becomes quite big. Almost half of the patients, during their first visit to the physician, show jaundice due to narrowing of the bile ducts. Such a state threatens the development of serious complications and requires timely stenting.
The optimal diagnostic program includes:
- consultation of the oncologist,
- clinical examination,
- case history collection,
- blood counts (for tumor markers, complete, biochemical)
- gastroscopy subject to sampling of samples for subsequent histological analysis,
- abdominal ultrasound,
- CT or MRI scan of the chest and abdomen,
According to the findings, the physician develops a therapy plan and shall decide on the need for surgery.
Course of Surgery
The intervention takes place under general anesthesia. Before stenting commencement, the X-ray image of the bile ducts is obtained. For this purpose, the ERCP procedure is performed. Under the endoscopic control, the surgeon inserts a probe into the common bile duct, through which it injects a radiopaque substance. After that the X-ray is performed.
The discovered constriction are expanded with bougies. Then, a set flexible tube (stent) is inserted into the affected site, which will maintain a normal lumen of the duct.
Stay in the clinic lasts up to 9 days. All this time, the patient is continuously watched by the medical staff. Symptomatic therapy is administered to facilitate the condition. Before discharge, the oncologist examines the patient and provides recommendations for further treatment.Hide