Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive painless jaundice, dark urine, and acholic stools. Associated symptoms include significant unintentional weight loss, epigastric discomfort radiating to the back, and new-onset anorexia. No history of biliary colic or fever.
Clinical Examination Findings
Physical examination reveals scleral icterus and generalized jaundice. Abdominal exam shows a non-tender, palpable gallbladder (Courvoisierโs sign) and mild epigastric tenderness. No evidence of ascites or hepatomegaly. Performance status is ECOG [Insert Grade].
Treatment Protocol
Plan: 1. Urgent biliary decompression via ERCP with stent placement. 2. Staging workup: CT abdomen/pelvis with pancreatic protocol and CA 19-9 levels. 3. Multidisciplinary tumor board referral for surgical candidacy (Whipple procedure) vs. neoadjuvant chemotherapy. 4. Nutritional support and pain management.