Endoscopic metal stenting of common bile duct for unresectable pancreatic cancer
Epublication WebSurg.com, Jun 2009;09(06). URL: http://websurg.com/doi/vd01en2665
Obstructive jaundice occurs in many patients with unresectable pancreatic cancer. Endoscopic therapy is the best palliative option for inoperable pancreatic cancers, either for the treatment of a potential duodenal stenosis or, in the majority of cases, for the treatment of the associated jaundice. Metal stents are preferable to plastic stents in patients who have a life expectancy of more than 3 months. The obstruction of the common bile duct is due to cancer of the head of the pancreas that compresses the biliary tree. However, in a few cases, the mucosa of the ampulla is also involved with malignancy from the adjacent pancreas. We present the case of two patients with unresectable pancreatic cancer, obstructive jaundice and pruritus, in which the drainage of the common bile duct was achieved with an Endoscopic Retrograde Cholangio-Pancreatography (ERCP) with insertion of an uncovered metal stent (Wallflex® type) with subsequent relief of the jaundice. Endoscopic drainage of the common bile duct for obstructive jaundice for unresectable pancreatic cancer is the preferred palliative approach in this type of patient.