Presentation
History of cholecystectomy about eight years ago. Recently diagnosed locally advanced unresectable pancreatic head ductal adenocarcinoma underwent a palliative biliary drain catheterization.
Patient Data
By injecting the contrast medium through a percutaneous transhepatic biliary drainage catheter, intra and extra-hepatic bile ducts and remnant cystic duct are visualized as dilated. The gallbladder is not visualized due to prior resection.
Three round filling defects are seen in the distal half of CBD inferring stones, accompanied by abrupt distal CBD cut-off, because of tumoral infiltration, without sign of contrast passage into the duodenum.
There is no evidence of contrast leakage into the peritoneal cavity.
Case Discussion
Relieving obstructive jaundice in unresectable pancreatic head ductal adenocarcinoma, distal biliary or periampullary malignancies improves the quality of life, permits chemotherapy and relieves jaundice but can be associated with significant morbidity and mortality due to cholangitis, sepsis, hemorrhage and stent blockage.
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