Скачать или смотреть This One Misunderstanding Delayed Cancer Surgery | Real Patient Story! | Dr Praveen Kammar

Hi, I’m Dr Praveen Kammar, Cancer Surgeon specializing in gastrointestinal and gynecological cancers.
In this video, I’ll explain the critical decisions that must be made before placing a stent in patients with obstructive jaundice, especially in cancer cases. I’ll walk you through a real patient scenario that highlights how improper planning can delay treatment and worsen outcomes.
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Video Flow
0:00 – Introduction
0:11 – Patient case overview: comorbidities and cancer diagnosis
0:56 – First plastic stent placement and recurring jaundice
1:51 – Repeated plastic stenting, infections, and ICU admission
2:46 – Family's misconception about metal stents
3:41 – Role of the cancer surgeon and the knowledge gap
4:21 – How metal stents are placed safely in operable cancers
5:06 – Why the patient’s surgical window closed due to poor planning
5:41 – Do all patients with jaundice need stenting?
6:01 – Conclusion
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This One Misunderstanding Delayed Cancer Surgery | Real Patient Story! | Dr Praveen Kammar

A Real Case: What Went Wrong
We had a patient with pancreatic head cancer—specifically at the region where the pancreatic and bile ducts meet the small intestine. The patient also had pre-existing heart issues and diabetes and was already on blood thinners. He developed jaundice, and a plastic biliary stent was inserted to relieve the blockage.
Initially, the bilirubin levels dropped, and the patient showed improvement. But within a few weeks, the jaundice returned. As I’ve explained in earlier videos, if jaundice doesn’t reduce steadily—or begins to rise again—it usually means the stent is blocked.

In this patient, repeated stenting was done with plastic stents, but each one eventually failed. The second attempt led to another infection episode, requiring ICU care. The third attempt also used a plastic stent, and again, the same cycle of partial relief and repeated infection followed.

Why a Metal Stent Was Never Used?
When we finally reviewed the entire case in detail with the family, we asked: Why wasn’t a metal stent placed?
Their answer was concerning. They had been told that metal stents are only used when surgery is no longer an option, and placing one means the cancer is inoperable. This is completely incorrect.
That misunderstanding led to poor decision-making because a cancer-treating surgeon was never involved in the early stages of planning. If a surgeon had been consulted from the start, we could have determined whether the disease was resectable and whether a metal stent could be safely placed without affecting future surgery.

The Cost of Delayed Surgical Planning
Because this patient underwent multiple plastic stent placements and suffered repeated infections, his overall health deteriorated. He was already high-risk due to his heart condition. Over time, he became medically unfit for surgery, even though his cancer remained operable. That’s a tragic loss of opportunity. If a metal stent had been placed during the first or second procedure, his condition might have stabilized and improved in time for surgery.
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About Dr. Praveen Kammar

Dr Praveen Kammar is a surgical oncologist practising in the city of Mumbai.
He completed his MCh course in surgical oncology from the reputed Tata Memorial Centre, Mumbai, one of the premier cancer care centres in the country. He also holds a fellowship in Colorectal surgery from Yopnsei cancer centre, Seoul, South Korea. Dr Praveen’s main area of focus is colorectal and GI oncology, Gynecological cancers, minimal access surgeries for abdominal and thoracic malignancies, transanal surgeries, and sphincter-saving surgeries for rectal cancer, cytoreductive surgeries, and HIPEC for advanced abdominal cancers.



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