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Part 8

Part 8. Therapeutics. Whipple’s procedure. a.k.a. Pancreaticoduodenectomy. Chemotherapy. Deoxycytidine analogue gemcitabine 1000 mg/m 2 weekly for 7 weeks followed by 1 week rest, then weekly for 3 weeks every 4 weeks thereafter. Percutaneous Biliary Drainage.

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Part 8

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  1. Part 8

  2. Therapeutics

  3. Whipple’s procedure • a.k.a. Pancreaticoduodenectomy

  4. 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

  5. Percutaneous Biliary Drainage • Percutaneous transhepaticbiliary 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 percutaneoustranshepaticcholangiodrainage.

  6. Indication for PTBD • To relieve obstructive jaundice when the endoscopic retrograde approach has failed or is not indicated

  7. September 2, 2011 St. Luke’s Medical Center Percutaneous Biliary Drainage

  8. Dilated common bile duct Needle

  9. Guide wire Cut off area

  10. Catheter Gallbladder

  11. Biopsy site

  12. Prognosis

  13. 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

  14. Thank you for your kind attention!

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