Indications preop stents.
Acute cholanfitis
Intense puritis
Neoadjuvant chemotherapy
- short length self expanding stent
Management of nonresectable cancers
- ercp and stent
- PTC mettalic stent if no ercp access
- Eus or us guided fna biopsy possible celiac plexus block
- if associated gastric outlet obstruction then double bypass or
duodenal stent
Operative management
- Any metastatic disease in pancreatic cancer - the patient is
unresectable
- staging laparoscopyuswd in some institutions but low yield
If non-resectable
- Trans duodenal trucut pancreatic biopsy
- palliative
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