Jaundice

One of the jobs of the liver is to process bilirubin, a yellow pigment that is formed when red blood cells in the body break down. Normally, the bilirubin passes through the bile duct to the bowel and then passes out of the body in stools (faeces).

With liver cancer, bilirubin sometimes builds up in the blood. This can be because the cancer has blocked a bile duct, the liver is not working properly (progressive liver function failure), or the liver has been replaced by widespread tumour.

The build-up of bilirubin in the blood is known as jaundice. It can cause yellowish skin and whites of the eyes, itchiness, pale stools or dark urine.

Jaundice can sometimes be relieved by unblocking the bile duct with a tiny tube called a stent (see below for how stents are inserted). Stenting is not always recommended in advanced cancer.

The itching caused by jaundice is often worse at night. It can be relieved to some degree by keeping your skin moisturised. Try to avoid alcohol, spicy food, hot baths and direct sunlight, which can make the itching worse. Medicine can be prescribed if the itching continues and is uncomfortable.


How stents are inserted

A stent can be placed in your liver to clear a blocked bile duct and relieve symptoms of jaundice. The earlier the stent is inserted, the less severe the symptoms. Stenting can be done in two ways.

How stents are inserted

Endoscopic stent placement

This is done as a day procedure. You will have a local anaesthetic and possibly a sedative to help you relax.

A gastroenterologist or surgeon will insert a long, flexible tube with a camera and light on the end (endoscope) through your mouth, stomach and small bowel into the bile duct. Pictures show up on a screen so the doctor can see where to put the stent. The stent is put in using the endoscope, which is then removed.

Recovery from an endoscopic stent placement is fairly fast. Your throat may feel sore for a short time and you may need to stay in hospital overnight.

After the procedure, the bile duct may become infected and the pancreas may become inflamed – your doctor will talk to you about what can be done if this occurs.

Percutaneous stent placement

Sometimes a stent cannot be inserted using an endoscope so it is placed through the skin, using ultrasound and x-rays for guidance. This requires a small operation.

The operation may be done under general anaesthetic or heavy sedation, and you will usually stay in hospital overnight. You may have a small plastic tube (drain) coming out through the skin for some days. This lets fluid drain from the area.


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To download an EPUB to your Kobo from a Mac:

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Turn on your Kobo and your EPUB will be located in “eBooks”, while a PDF will be located in “Documents”.
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Sony Reader

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  • open the Reader™ Library software and click “Library” in the left-hand pane and select the eBook to view it.

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Amazon Kindle 2nd Generation devices

EPUB files can’t be read on the Amazon Kindle™. However, like most eReaders, Kindle™ 2nd Generation devices are able to display PDFs. We recommend that you download the PDF version of this booklet if you would like to read it on a Kindle™.
To transfer a PDF to your Kindle™ via USB cable from your computer or Mac:

  • download the PDF directly onto your computer.
  • connect the USB cable to your computer’s USB port, and the micro USB end of the cable to your Kindle™. Note: the Kindle™ won’t be available as a reading device while it is connected to your computer until it has been disconnected.
  • open the Kindle™ drive and several folders will appear inside. The “Documents” folder is where you will need to copy or drag the PDF to.
  • safely eject your Kindle™ from your computer and unplug the USB cable. Your content will appear on the Home Screen.

Kindle also provides a Kindle Personal Documents Service that allows users to send documents as an attachment directly to your eReader. For more information on this service, visit http://www.amazon.com/gp/help/customer/display.html/ref=help_search_1-1?ie=UTF8&nodeId=200767340&qid=1395967989&sr=1-1
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Android and PC

You can also download and open eBooks on Android devices and PCs with appropriate apps or software installed. Suitable eReader apps for Android include Google Play Books, FBReader and Moon+ Reader. Suitable software for PCs include Calibre and Adobe Digital Editions.


This information was last reviewed in June 2018
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