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PRE-IRE BT

66Y, ERKEK LOKAL İLERİ PANKREAS CA (LAPC) (İNVAZİF DUKTAL CA) İNOP 5 KÜR KT + 28 GÜN RT 3 HAFTA ÖNCE DIŞ MERKEZDE ENDOSKOPİK BİLİER STENT. PRE-IRE BT. PRE OP LAB. DİREK / TOTAL BİLİRUBİN : 3,4 / 4,3 KCFT : NORMAL PTZ VE INR: NORMAL CA 19-9: 4801 HEMOGRAM: NORMAL. YAPILAN.

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PRE-IRE BT

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  1. 66Y, ERKEK LOKAL İLERİ PANKREAS CA (LAPC) (İNVAZİF DUKTAL CA)İNOP5 KÜR KT + 28 GÜN RT3 HAFTA ÖNCE DIŞ MERKEZDE ENDOSKOPİK BİLİER STENT

  2. PRE-IRE BT

  3. PRE OP LAB • DİREK / TOTAL BİLİRUBİN : 3,4 / 4,3 • KCFT : NORMAL • PTZ VE INR: NORMAL • CA 19-9: 4801 • HEMOGRAM: NORMAL

  4. YAPILAN • İNTRAOPERATİF ELEKTROPORASYON • USG EŞLİĞİNDE VASKÜLER YAPILARA DİKKAT • PANKREASTAKİ KİTLEYE • KC SEG 3 METASTAZA • TÜP JEJUNOSTOMİ • KİTLE EKSİZYONU • İNTRAOPERATİF RDUS: • PATENT ANCAK DAR SMA VE SMV

  5. POST-IRE-BT

  6. POST OP 5. GÜN • ORAL ALIM İLE KARIN AĞRISI • PANKREATİT YOK • MEZENTER İSKEMİSİ?

  7. KARIN AĞRISI- MVO?

  8. SEBEP ?

  9. 4X30 MM

  10. POST OP 39. GÜN • HEMAYOKEZYA + HEMATEMEZ • TA: 50 mmHg • TRB:175000 • INR:1,84 • PTZ:20

  11. TEDAVİ SEÇENEĞİ • GREFT KAPLI STENT • ELDE YOK, GETİRTMEK ZAMAN KAYBI • SMA EMBOLİZASYONU • JEJUNEKTOMİ ? • AKIM ÇEVİRİCİ STENT? • KOİL EMBOLİZASYONU • SMA’YA PROTRUDE OLUR

  12. 6X30 MM 18X55,14X30,7X17

  13. 7X40 MM WALLSTENT 6-10X30,5X6,3-6X5

  14. 1.GÜN KONTROL

  15. 10 GÜN SONRA • HEMORAJIK INME • 2 GUN SONRA EXITUS

  16. IRREVERSIBL ELEKTROPORASYON (IRE)

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