Duodenal obstruction in advanced pancreatic cancer treated by percutaneous endoscopic gastrostomy based on ethical considerations: A case report
10.2512/jspm.9.501
- VernacularTitle:減圧目的の経皮内視鏡的胃瘻造設術によりQOL改善を認めた終末期膵がんの1例
- Author:
Tetsuo Konishi
;
Yoshiyuki Kodama
;
Yasuhiro Nagaoka
;
Haruyuki Yoshida
- Publication Type:Journal Article
- Keywords:
PEG (percutaneous endoscopic gastrostomy) for decompression;
clinical ethics;
quality of life;
palliative care
- From:Palliative Care Research
2014;9(2):501-505
- CountryJapan
- Language:Japanese
-
Abstract:
Purpose: We report an advanced pancreatic cancer case with duodenal obstruction successfully treated with percutaneous endoscopic gastrostomy (PEG). Our team, with a common understanding based on ethical considerations, determined how to treat this patient and devised a technically advanced PEG.
Case report: A woman in her 80s with advanced pancreatic cancer received best supportive care. However, she developed duodenal obstruction and could not eat. Therefore, we placed a PEG for decompression based on ethical considerations. We were careful to avoid gastrostomy tube obstruction or peritonitis caused by regurgitation of stomach contents. Her quality of life (QOL) improved when she regained the ability to eat and she returned home.
Conclusion: As to the ethical considerations, a conference the 4 contingency table of team－based clinical ethics was found to be effective. The QOL of this patient improved when ingestible food or PEG for decompression was applied.
