Palliative Management
Types of metallic stents.
Radiologist passing stent.
Plain film showing stent in situ.
Photograph of resected segment of colon with stent in- situ.
Palliative Management
Unfortunately, patients can present with LBO for which surgery may not be indicated or inadvisable.
Possible contraindications for major surgical approach.
- Very frail elderly patient
- Patient unfit for anaesthesia (may only relate to initial presentation)
- Evidence of disseminated disease
- Poor life expectancy
Palliative techniques
- Diversionary stomas under LA
- Stenting of strictured area
Diversionary stomas are:
- Rarely performed
- Very difficult procedures
- Produce high complication rate
Stenting
The principles behind stenting are:
- Place a stent through the stenotic area by radiologist/endoscopist
- Deflate proximal bowel
- Turn emergency into elective situation
- Allows proper preparation and assessment of patient
- Proceed to elective operation
