[Care of tumor patients with biliary-duodenal drainage by the family physician. Treatment of extrahepatic biliary obstruction].

Ambulatory care of patients with tumors of the biliary system and pancreas undergoing bilioduodenal drainage for obstructive jaundice is increasingly being provided by the family doctor in cooperation with an endoscopy center. The greatest risk for the patient is the development of acute cholitis caused by blockage of the endoprosthesis with the need for immediate replacement of the latter. Apart from the clinical examination, laboratory data and ultrasonography are often required to establish the diagnosis and enable an adequate assessment of the bile flow situation to be made. Additional diagnostic procedures (e.g. endosonography and computed tomography) are needed only for the primary diagnostic work-up. The data obtained from our patients show that family doctors are well attuned to the leading symptoms, and that delays in acting on suspected obstruction of the biliary stent rarely occur.