Part 8

THERAPEUTICS

• a.k.a. Pancreaticoduodenectomy

Whipple’s procedure

Chemotherapy

• Deoxycytidine analogue gemcitabine

– 1000 mg/m2 weekly for 7 weeks followed by 1 week rest, then weekly for 3 weeks every 4 weeks thereafter

• Percutaneous transhepatic biliary drainage is used preoperatively to decompress the biliary tree and prevent complications aggravated by bile spillage.

• Drainage of the biliary tree by the introduction of a catheter through the liver and into the biliary tree under radiologic guidance. Also called percutaneous transhepatic cholangiodrainage.

Percutaneous Biliary Drainage

Indication for PTBD

• To relieve obstructive jaundice when the endoscopic retrograde approach has failed or is not indicated

PERCUTANEOUS BILIARY DRAINAGESeptember 2, 2011

St. Luke’s Medical Center

Needle

Dilated common bile duct

Guide wire

Cut off area

Catheter

Gallbladder

Biopsy site

PROGNOSIS

Prognosis

• Median survival time for all patients is 4-6 months.

• Patients who survive for 5 years after successful surgery may still die of recurrent disease years after the 5-year survival point.

• The occasional patient with metastatic disease or locally advanced disease who survives beyond 2-3 years die of complications

THANK YOU FOR YOUR KIND ATTENTION!