Duodenal obstruction in advanced pancreatic cancer treated by percutaneous endoscopic gastrostomy based on ethical considerations: A case report

ABSTRACT

<b>Purpose</b> 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.<BR><b>Case report</b> 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.<BR><b>Conclusion</b> 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.