chemamr
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Carcionid Sx: octreotide controls symptoms. You should remove surgically or with radioablation the carcinoid tumor.
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| chemamr
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You can´t remove only the pancreatic head or only the duodenum or only the common bile duct, it´s a surgical piece (i guess  ). Besides that, cholangiocarcinoma has a very bad prognosis because metastasize very fast, so treatment must be aggressive and radical.
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| drkpp
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remember most of the times pancreatic duct joins the bile duct to open into the ampulla of vater. if bile duct is removed so wld the pancreatic duct opening.
thus the duodenum is cut into a rouux-en-y and joined with the pancrease. its called pustov's operation..
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| chemamr
Moderator and PGY2
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Do you mean Puestow´s procedure?
Puestow´s procedure is used for chronic pancreatitis, too.
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| drkpp
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yes i meant puestows
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| chemamr
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| sumie
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thanks guys
why is octreotide used in carcinoid
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sumie
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| chemamr
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octreotide is the synthetic analog of somatostatin, thus inhibits multiple hormones (which are secreted by a carcinoid tumor).
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| ARJ
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Octreotide does inhibits 5HT (serotonine) but also it decreases the side effects caused by excess of 5TH ie Watery Diarrhea and Flushing which is seen in carcinoid syndrome by increasing the reabsorption of fluid and electrolyte from the lumen. Also it is used in diarrhea caused by VIP secreting Tumor.
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