GOOD-evening. If the cancer of pancreas in your friend s case is localised to pancreas only then the ideal way was to operate it upfront and remove the mass; that would have taken care of the bile also. If we drain bile first and then operate in a localised cancer( as done in your friends case), it increase chances of post operative sepsis(infection). However if it is metastatic, then doctor have done goof to drain the bile as the operation is not feasible in a metastatic case. Now if the bilirubin level comes down to less than 3 mg.dl then only can further treatment(chemotherapy) can be planned. She can be given narcotics pain killers to releive the pain. The prognosis of pancreatic cancer is poor. In a localised case median survival is 2 years. While in a metastatic disease the median survival in 10 - 12 months.