[The palliative role of percutaneous endoscopic gastrostomy with jejunal extension (PEG-J) in an advanced pancreatic cancer patient with duodenal stenosis--a case report].
Although a 64-year-old man with pancreatic cancer was referred to our hospital due to difficulty in the bile drainage, he was initially planned to have an operation at another hospital after relief of obstructive jaundice. Laboratory tests on admission revealed obstructive jaundice, pancreatitis and malnutrition (T-Bil 12.1 mg/dL, AMY 1170 IU/L, Alb 2.0 g/dL). Abdominal computed tomography (CT) detected a pancreas tumor and multiple liver metastases. Then, we determined to carry out palliative therapy. Percutaneous transhepatic cholangiography (PTC) showed a common bile duct obstruction, and a biliary metallic stent was placed. Endoscopic examination revealed a tumorous duodenal stenosis. We performed percutaneous endoscopic gastrostomy with jejunal extension (PEG-J), which was used for both transintestinal nutrition and decompression gastrostomy. After these therapies, the patient's condition improved better in 2 weeks as such that he could have stayed away from our hospital for several days. PEG-J was useful to improve a quality of life in pancreatic cancer patient with duodenal stenosis.
Nakahira
Shin
S
Dept. of Digestive Surgery, Kansai Rosai Hospital.
Sugimoto
Keishi
K
Okamura
Syu
S
Miki
Hirofumi
H
Nakata
Ken
K
Suzuki
Rei
R
Okada
Kaoru
K
Miyake
Tomohiro
T
Yoshimura
Mio
M
Tamura
Shigeyuki
S
D003251:Constriction, Pathologic / Q000473:pathology*; D004380:Duodenal Obstruction / Q000473:pathology* / Q000601:surgery; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D007565:Jaundice / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D014057:Tomography, X-Ray Computed