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Yellowing of the skin and eyes because a tumour blocks the bile duct, most often pancreatic or bile duct cancer. It causes itching, infection risk and dark urine, and it must be relieved (usually with a stent) before chemotherapy can be given safely.
Most pancreatic head, distal bile duct and ampullary cancers present with painless jaundice; perihilar cholangiocarcinoma obstructs higher up. Bilirubin above about 1.5× normal precludes most chemotherapy (irinotecan, taxanes and many TKIs are cleared by the liver), so ERCP-placed metal stents or percutaneous drainage come first, with antibiotics for cholangitis. Other malignant obstructions treated by stenting, surgery or radiotherapy include gastric outlet, bowel (managed medically with octreotide and steroids in advanced disease, or surgically), airway, superior vena cava (SVC syndrome) and ureteric obstruction causing hydronephrosis, which impairs cisplatin eligibility in bladder and cervical cancer.
Shares Stent or bypass for jaundice: the choice, Living with jaundice and itching (biliary cancer), Biliary drainage routes: ERCP stent, percutaneous (PTC) and EUS-guided, TESLA RCT.
Shares Symptom control in advanced gallbladder cancer: pain, ascites and nutrition, Stenting (biliary, oesophageal, airway), Endoscopy (EGD, EUS, ERCP), Gallbladder cancer.
Shares High-risk stigmata and worrisome features of pancreatic cysts (IPMN and MCN surgical criteria), Ampullary cancer (ampulla of Vater), Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors, Locally advanced unresectable pancreatic ductal adenocarcinoma.
Shares Pancreas protocol CT (pancreatic protocol CT, dual-phase thin-slice CT with structured reporting), High-risk stigmata and worrisome features of pancreatic cysts (IPMN and MCN surgical criteria), Palliation in pancreatic cancer: biliary and duodenal stents, coeliac plexus block, enzymes and cachexia, Endoscopy (EGD, EUS, ERCP).
Shares When to seek urgent help with gallbladder cancer (NHS 111 and 999), Cholangitis: infection of a blocked bile duct, Gallbladder cancer.
Shares When to seek urgent help with gallbladder cancer (NHS 111 and 999), Cholangitis: infection of a blocked bile duct, Gallbladder cancer.
Shares Palliation in pancreatic cancer: biliary and duodenal stents, coeliac plexus block, enzymes and cachexia, Locally advanced unresectable pancreatic ductal adenocarcinoma, Resectable pancreatic ductal adenocarcinoma, Metastatic pancreatic ductal adenocarcinoma.
Shares Symptom control in advanced gallbladder cancer: pain, ascites and nutrition, Pancreatic enzyme replacement therapy (PERT, pancreatin, Creon) for pancreatic exocrine insufficiency: why and how to take it, Palliation in pancreatic cancer: biliary and duodenal stents, coeliac plexus block, enzymes and cachexia, Locally advanced unresectable pancreatic ductal adenocarcinoma.