Differentiated approach to the minimally invasive management of malignant obstructive jaundice
| Autor: | P. S. Vetshev, G. G. Akhaladze, E. I. Galperin, T. G. Dyuzheva |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Cellular immunity Chemotherapy Biliary drainage Hepatology business.industry Bile duct medicine.medical_treatment Gastroenterology 030230 surgery Surgery law.invention 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Randomized controlled trial law 030220 oncology & carcinogenesis Medicine Obstructive jaundice In patient Radical surgery business |
| Zdroj: | Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 24:10-24 |
| ISSN: | 2408-9524 1995-5464 |
| Popis: | Attitude towards preoperative biliary drainage for malignant obstructive jaundice have recently changed twice. This is due certain factors including complications of minimally invasive biliary drainage, level of bile duct block, cholangitis, need for neoadjuvant chemotherapy, time to scheduled surgery, severe general condition of patient, future liver remnant volume. We comprehensively searched PUBMED, MD Consult and National Library of Medicine using the following keywords: “obstructive jaundice (OJ)”, “cellular immunity”, “preoperative biliary drainage”, “selective biliary drainage”, “distal and proximal bile duct block”, “complications”. Randomized clinical trials and meta-analyzes, opinions of reputable specialists in hepatopancreatobiliary surgery and our own experimental and clinical studies were foreground. The analysis showed that preoperative biliary drainage is not a safe procedure and results an increased number of complications. Absolute indications for preoperative biliary drainage are cholangitis, need for neoadjuvant chemotherapy, increased risk of radical surgery and unresectable tumor. Future liver remnant volume should be considered in patients with portal cholangiocarcinoma followed by proximal block to determine indications for preoperative biliary drainage. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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