Palliative Surgery in Pancreatic Cancer

Posted by e-Medical PPT Thursday, May 3, 2012
Case
53M with jaundice x 3 weeks
Mild abdominal pain 9/04
PMH: negative
No abd masses, nontender
Bilirubin 22
CT: pancreatic mass @ head

Resectable?
At presentation:
50% with metastatic disease
40% locally advanced
10% confined disease
Only 20% deemed resectable
80% unresectable:
Local invasion ----> 6 month median survival
Stage IV ----->3 months

Palliation
Primary goal for majority of patients
Obstructive jaundice
Gastric outlet syndrome
Pain

Surgical:
Hepaticojejunostomy
Choledochojejunostomy
Choledochoduodenostomy
Cholecystojejunostomy

Non-surgical:
ERCP (plastic or metal)
Transhepatic




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