If the tumour is pressing on the common bile duct, it can cause a blockage and prevent bile from passing into the bowel.
Bile builds up in the blood, causing symptoms of jaundice, such as:
- yellowing of the skin and whites of the eyes
- itchy skin
- reduced appetite, poor digestion and weight loss
- dark urine
- pale stools.
If cancer blocks the duodenum (first part of the small bowel), food cannot pass into the bowel and builds up in your stomach, causing nausea and vomiting.
Blockages of the common bile duct or duodenum are known as obstructions.
Surgical options for managing these may include:
| stenting | Inserting a small tube into the bile duct or duodenum (this is the most common method). |
| bypass surgery | Connecting the small bowel to the bile duct or gall bladder to redirect the bile around the blockage, and connecting a part of the bowel to the stomach to bypass the duodenum so the stomach can empty properly. |
| gastroenterostomy | Connecting the stomach to the jejunum (middle section of the small bowel). |
| venting gastrostomy | Connecting the stomach to an opening in the abdomen so waste can be collected in a small bag outside the body. |
Sometimes the surgeon may have planned to remove a pancreatic tumour but discovers during the surgery that the cancer has spread. If the tumour cannot be removed, the surgeon may perform one of the operations listed above to relieve symptoms.
For more on this, see our general section on Surgery.
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Prof Lorraine Chantrill, Honorary Clinical Professor, University of Wollongong, and Head of Department, Medical Oncology, Illawarra Shoalhaven Local Health District, NSW; Karen Baker, Consumer; Michelle Denham, 13 11 20 Consultant, Cancer Council WA; Prof Anthony J Gill, Surgical Pathologist, Royal North Shore Hospital and The University of Sydney, NSW; A/Prof Koroush Haghighi, Liver, Pancreas and Upper Gastrointestinal Surgeon, Prince of Wales and St Vincent’s Hospitals, NSW; Dr Meredith Johnston, Radiation Oncologist, Liverpool and Campbelltown Hospitals, NSW; Dr Brett Knowles, Hepato-Pancreato-Biliary and General Surgeon, Royal Melbourne Hospital, Peter MacCallum Cancer Centre, and St Vincent’s Hospital, VIC; Rachael Mackie, Upper GI – Clinical Nurse Consultant, Peter MacCallum Cancer Centre, VIC; Prof Jennifer Philip, Chair of Palliative Care, University of Melbourne, and Palliative Medicine Physician, St Vincent’s Hospital, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, VIC; Lucy Pollerd, Social Worker, Peter MacCallum Cancer Centre, VIC; Rose Rocca, Senior Clinical Dietitian – Upper GI, Peter MacCallum Cancer Centre, VIC; Stefanie Simnadis, Clinical Dietitian, St John of God Subiaco Hospital, WA.
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