HPB DAY. Plan today 4 cases Images Present range of approaches Discussion. 38 year old female, 6 month history of recurrent attacks of severe epigastric pain -> back. Possibly dark urine at times USS….
Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.
Present range of approaches
Or how I learned to stop worrying and love the gallstone…
38 year old female, 6 month history of recurrent attacks of severe epigastric pain -> back. Possibly dark urine at times
5 days postop readmitted with severe abdominal pain…..
Why, what investigations
What else …
OK LFTs but so what
USS: CBD 16mm GB distended, no stones
CT scan – unresectable ca pancreas
Stent - route
Self-expanding stent placed in the CBD of patient with non-resectable pancreatic tumour
(Biopsy) – including EUS
47 year old male. 3 year history of epigastric pain -> back. Rather constant. Worsening over 6 months. Stools recently rather loose.
69 year old male referred with an inguinal hernia. Looks terrible. Admits to 3 months of anorexia, lethargy and weight loss.
Local treatments ….
Don’t forget CBD stones
ERCP is principally for therapy now
Save time, do the right test, ask a radiologist
Tissue diagnosis not always possible in pancreatic cancer
Time is critical in obs jaundice
Good palliation from biliary decompression
CA 19/9 for pancreatic cancer
GEMCITABINE for pancreatic cancer