期刊论文详细信息
Cancers
Palliative Interventional and Surgical Therapy for Unresectable Pancreatic Cancer
Volker Assfalg1  Norbert Hüser1  Christoph Michalski1  Sonja Gillen1  Jorg Kleeff1 
[1] Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, D-81675 Munich, Germany;
关键词: pancreatic cancer;    palliative pancreatic surgery;    neoadjuvant therapy;    duodenal obstruction;    jaundice;    prophylactic gastroenterostomy;   
DOI  :  10.3390/cancers3010652
来源: mdpi
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【 摘 要 】

Palliative treatment concepts are considered in patients with non-curatively resectable and/or metastasized pancreatic cancer. However, patients without metastases, but presented with marginally resectable or locally non-resectable tumors should not be treated by a palliative therapeutic approach. These patients should be enrolled in neoadjuvant radiochemotherapy trials because a potentially curative resection can be achieved in approximately one-third of them after finishing treatment and restaging. Within the scope of best possible palliative care, resection of the primary cancer together with excision of metastases represents a therapeutic option to be contemplated in selected cases. Comprehensive palliative therapy is based on treatment of bile duct or duodenal obstruction for certain locally unresectable or metastasized advanced pancreatic cancer. However, endoscopic or percutaneous stenting procedures and surgical bypass provide safe and highly effective therapeutic alternatives. In case of operative drainage of the biliary tract (biliodigestive anastomosis), the prophylactic creation of a gastro-intestinal bypass (double bypass) is recommended. The decision to perform a surgical versus an endoscopic procedure for palliation depends to a great extent on the tumor stage and the estimated prognosis, and should be determined by an interdisciplinary team for each patient individually.

【 授权许可】

CC BY   
© 2011 by the authors; licensee MDPI, Basel, Switzerland.

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