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Treatment for obstructive jaundice with diabetes - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Liver and Gall Bladder
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
User :   This is about my father who is 80 and has a history of over 26 years of diabetes - and insulin dependent for past 11 years. He has been recently diagnosed as having "obstructive jaundice" - the CE CT report talks of the presence of a lesion in the right biliary duct and confirms cirrhosis of the liver.
What treatment would you suggest? Would you recommend a curative approach or a conservative, palliative management?
Doctor :   hi
Doctor :   Dr xxx here
Doctor :   i am going through ur history
User :   Thanks Dr xxxx
Doctor :   give me a minute
User :   Sure doctor
Doctor :   at the age of 80 yrs, and with having so much of issues like diabetes and cirrhosis, the chances of complete recovery would be less
Doctor :   and aggressive treatment , with modalities, like surgery can cause more health issues than give him cure
User :   So, what is your view on controlling jaundice?
User :   As part of conservation, palliative approach
Doctor :   can u specify, what lesion has been found on the USG
User :   Hold on pls
Doctor :   SO as to know, whats the diagnosis for obstructive jaundice?
User :   The CT report at the end says " Impression: Hilar cholangiocarcinoma
User :   Cirrhosis with portal hypertension'
Doctor :   this i guess, is cancer in the bile ducts
User :   Periportal Lymphadenopathy - metastatic?
Doctor :   which is in stage 3 ,
User :   yes that is what they tell us...and so like u they tell us that surgery is unadvisable given his age and condition
Doctor :   there is no point of surgery at this stage (for cure)
Doctor :   but to relieve the jaundice, they can probably try to place a metalic stent in the gall bladder, which can relieve the obstruction
User :   How reliable is stent? Will it need frequent changing?
Doctor :   the procedure is one time
Doctor :   and can be a palliative step to relieve the jaundice
User :   Do u recommend...
Doctor :   but any procedure, may be minimal invasive, can cause furthter spread of the cancer and lodge it into further sites
User : u recommend stent by endoscopic method or percutaneous method
Doctor :   at this age, even minimal surgey, like stent placement, would depend on the physical examination assessed by seeing the patient
Doctor :   percutaneous route - is the best according to me
User :   In Chennai..which is the place u recommend for percutaneous procedure?
Doctor :   doing a endoscopy can increase the morbidity
Doctor :   give me a minute
Doctor :   Kkr cancer hospital oncology
User :   any doctor's name? i understand they will need support of a good interventional radiologist
Doctor :   CALL at 044 1111111111111
User :   is that the number of kkr cancer hosp?
Doctor :   this is the no of KKR hospital
Doctor :   you can get additional info from this no
Doctor :   give me a minute, so that i get some additional info
User :   Thank you doctor..may ia sk u another question?
Doctor :   sure
User :   Are you a GP, a surgeon or oncologist..or?
Doctor :   I have experiece in oncology for 5 years as a senior resident
User :   Thanks..much, is there any additional info from you?
Doctor :   the other place in chennai is
User :   What about MIOT hospital? Have you heard of them
Doctor :   CHECK this link for more info
Doctor :   MIOT is also a good hospital
User :   OK..sure..thanks..
User :   anything else for now doc?
Doctor :   check out for the experience of the doctors in appolo, and you will gain info , about further treatment
Doctor :   also, you can visit the websites of these hospitals,
Doctor :   and get additional info
User :   Thanks Doc..much appreciate...have a good evening
Doctor :   i hope, the pain for your father reduces, with proper treatment
Doctor :   take care and bye for now
User :   Bye Doc
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