Palliative Care Of Malignant Biliary Tumors

Obstructive jaundice can be caused by pancreatic head cancer, ampullary cancer, and biliary malignancy. Most of these patients are elderly, or accompanied by basic heart, brain and lung diseases, and most of them are found in the late stage, unable to tolerate surgery or have no opportunity for surgery.

Biliary obstruction can cause increased biliary pressure, resulting in yellow skin sclera staining; It can also cause swelling of liver cells, resulting in impaired liver cell function and even multiple organ dysfunction. At this time, bile drainage can reduce the biliary pressure, improve liver function, relieve the pain of patients, improve the quality of life of patients.

Bile drainage methods include: percutaneous puncture needle, endoscopic bile drainage (EPD) and choledojejunostomy. Among them, PTCD is widely used. PTCD can drain bile through internal and external drainage. For patients with malignant obstructive jaundice, the guide wire is not easy to narrow during the operation, and simple external drainage is more common. The distal end of the multi-lateral fora catheter can achieve internal drainage through stenosis, which is similar to physical bile drainage. Compared with external drainage, this method has less bile loss and less impact on intestinal function, so it is more respected. Stent placement through PTCD tube can also achieve internal drainage through the narrow segment, which has become an important palliative therapy for the treatment of biliary malignancy. In addition, further radiotherapy after PTCD implantation with I particles through catheter is also clinically effective.