Conversation: The conversation between human and AI assistant.
[|Human|] Case history:-72 years old patienta sizable intra-abdominal mass occupying the right hypochodrium. Ultrasonography and Ct scans gave the impression that the mass may be extrapancreatic or related to the uncinate process. The mass was also indenting the IVC but was not infiltrating it. He had no jaundice and was of reasonable body status. Guided FNAC was done and suggested undifferentiated adenocarcinoma as the pathology. Bearing in mind that there was a solitary liver lesion at segment VI, Limited exploration was performed with the hope that this lesion me be GIST tumour and the possibility of having the primary resected may help the patient. Unfortunately the tumour was found to be purely pancreatic invoving part of the head and encroaching on duodenal lumen and inseparable from IVC. In view of the previous findings only anterior gastrojujenostomy was performed to the patient to avoid future duodenal obstruction. His recovery was smooth apart from attacks of bilious vomiting probably related to the gastrojujenostomy. He has severe anorexia probaly related to his malignancy. He is now suffering from severe anorexia + cachixia+Regular vomiting (Fluid therapy is applied regularly)The surgeon is advising to perform another surgery to make a tube outside the body to give him food through it.  kINDLY GIVE THE ADVICE REGARDING THIS OPERATIONNB.Doctores did not decide to give him any kind of chemotherapy
[|AI|]  Hello dear. I have gone through the details. Si it seems an unresectable pancreatic cancer with a suspicious liver lesion. Approach would be to do an FNAC of the liver lesion if it is metastasis then do palliative therapy. If no then do initial chemo or radio chemo to shrink the tumor and make it respectable. Since pancreatic tumors cause severe cathexis and loss of appetite and also patient is vomiting, it is a good approach to do a feeding gastrostomy or jejunostomy to provide adequate nutrition. You can go for this operation. Rest of the approach I have mentioned. Hope it is clear. Thanks