Current role of palliative interventions in advanced pancreatic cancer.

Autor:	Ciambella CC; Department of Surgical Oncology, Warren Alpert Medical School Brown University, Providence, RI 02906, United States., Beard RE; Department of Surgical Oncology, Warren Alpert Medical School Brown University, Providence, RI 02906, United States., Miner TJ; Department of Surgical Oncology, Warren Alpert Medical School Brown University, Providence, RI 02906, United States. tminer@usasurg.org.
Jazyk:	angličtina
Zdroj:	World journal of gastrointestinal surgery [World J Gastrointest Surg] 2018 Oct 27; Vol. 10 (7), pp. 75-83.
DOI:	10.4240/wjgs.v10.i7.75
Abstrakt:	Pancreatic adenocarcinoma is the third leading cause of cancer death in the United States. Unfortunately, at diagnosis, most patients are not candidates for curative resection. Surgical palliation, a procedure performed with the intention of relieving symptoms or improving quality of life, comes to the forefront of management. This article reviews the palliative management of unresectable pancreatic cancer, including obstructive jaundice, duodenal obstruction and pain control with celiac plexus block. Although surgical bypasses for both biliary and duodenal obstructions usually achieve good technical success, they result in considerable perioperative morbidity and mortality, even when performed laparoscopically. The effectiveness of self-expanding metal stents for biliary drainage is excellent with low morbidity. Surgical gastrojejunostomy for duodenal obstruction appears to be best for patients with a life expectancy of greater than 2 mo while endoscopic stenting has been shown to be feasible with good symptom relief in those with a shorter life expectancy. Regardless of the palliative procedure performed, all physicians involved must be adequately trained in end of life management to ensure the best possible care for patients. Competing Interests: Conflict-of-interest statement: There is no conflict of interest associated with the senior author or other coauthors that contributed their efforts in this manuscript.
Databáze:	MEDLINE
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