Biliary drainage should be done before pancreatic cancer surgery

In clinical practice, pancreatic cancer patients often need biliary drainage before surgery. Why is this?

Purpose of biliary drainage

Patients often need biliary drainage to improve liver function and general condition in preparation for surgical intervention.

Inspection process

The process of percutaneous and transhepatic biliary drainage includes: angiography can be performed first, followed by further puncture and drainage:

1. Preoperative preparation: The patient follows the doctor's instructions to eat or fast to cooperate with biliary drainage.

2. The doctor may first perform percutaneous transhepatic cholangiography (PTC) with a 22-gauge fine needle to determine the location and nature of the lesion.

3. Based on the angiography results, the doctor can select a thicker, straighter, horizontal bile duct for internal drainage cannulation.

4. The doctor uses the 8th intercostal space on the right midaxillary line as the puncture point, and after local anesthesia, pokes a small hole in the skin with a sharp knife. The patient should cooperate with pausing breathing at this time. The doctor can quickly insert the thick needle into the pre-selected bile duct under TV monitoring. After a breakthrough feeling of entering the bile duct, pull out the needle core, wait for the bile to flow out smoothly, insert the guide wire, and continuously rotate and change the direction to make the guide wire pass through the obstruction end or stenosis segment into the distal bile duct or duodenum, withdraw the puncture needle, use the dilation tube to expand the channel, and then pass the multi-side hole catheter with the guide wire through the obstruction end or stenosis segment, so that the side hole of the catheter is located above or below the obstruction end or stenosis segment, fix the catheter, and inject contrast agent to take a film after the bile flows out smoothly from the catheter.

5. One week after drainage, the patient can undergo angiography again to observe the position of the catheter and the drainage effect.