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Can another surgery to put a tube outside the body for food be done on a 72 year old who has already had a gastrojujenostomy ?

Case history:- 72 years old patient a sizable intra- abdominal mass occupying the right hypochodrium. Ultrasonography and Ct scans gave the impression that the mass may be extrapancreatic or related to the uncinate process. The mass was also indenting the IVC but was not infiltrating it. He had no jaundice and was of reasonable body status. Guided FNAC was done and suggested undifferentiated adenocarcinoma as the pathology. Bearing in mind that there was a solitary liver lesion at segment VI, Limited exploration was performed with the hope that this lesion me be GIST tumour and the possibility of having the primary resected may help the patient. Unfortunately the tumour was found to be purely pancreatic invoving part of the head and encroaching on duodenal lumen and inseparable from IVC. In view of the previous findings only anterior gastrojujenostomy was performed to the patient to avoid future duodenal obstruction . His recovery was smooth apart from attacks of bilious vomiting probably related to the gastrojujenostomy. He has severe anorexia probaly related to his malignancy. He is now suffering from severe anorexia + cachixia+Regular vomiting (Fluid therapy is applied regularly) The surgeon is advising to perform another surgery to make a tube outside the body to give him food through it. kINDLY GIVE THE ADVICE REGARDING THIS OPERATION NB.Doctors did not decide to give him any kind of chemotherapy
Asked On : Sun, 2 Jan 2011
Answers:  1 Views:  70
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Orthopaedic Surgeon 's  Response

Thanks for writing to us.

A pancreatic tumor is always diagnosed late, invades surrounding structures badly and only palliative treatment is given to the patient. The decision to go for another surgery depends on the life expectancy of the patient. The surgery will help in his feeding and will help him live a little longer. The final decision is yours.

I hope this information has been both informative and helpful for you.


Dr. Praveen Tayal

Answered: Thu, 13 Oct 2011
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