Preoperative biliary drainage for pancreatic cancer
Pancreatic cancer is a leading cause of cancer-related morbidity and mortality, but any meaningful improvement in its prognosis remains elusive. The lack of early diagnostic methods means that many patients only present when symptoms develop, such as obstructive jaundice. Once a diagnosis of pancrea...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Society of Gastrointestinal Intervention
2018-07-01
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| Series: | Gastrointestinal Intervention |
| Subjects: | |
| Online Access: | https://doi.org/10.18528/gii180017 |
| _version_ | 1811270209691975680 |
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| author | Osman Ahmed Jeffrey H. Lee |
| author_facet | Osman Ahmed Jeffrey H. Lee |
| author_sort | Osman Ahmed |
| collection | DOAJ |
| description | Pancreatic cancer is a leading cause of cancer-related morbidity and mortality, but any meaningful improvement in its prognosis remains elusive. The lack of early diagnostic methods means that many patients only present when symptoms develop, such as obstructive jaundice. Once a diagnosis of pancreatic cancer has been made in a patient with obstructive jaundice, then a decision should be made if the patient is a candidate for surgical resection. Patients who are candidates for surgical resection generally do not need preoperative biliary drainage, unless they present with cholangitis, or if they require neo-adjuvant chemotherapy. If preoperative biliary drainage is to be done, then patient factors and local expertise should guide appropriate interventions. The evidence for endoscopic retrograde cholangiopancreatography as a first-line therapy for biliary decompression is strong; However, the use of percutaneous transhepatic biliary drainage as well as endoscopic ultrasound-guided biliary drainage has generally not been found to be inferior. Finally, to ensure ongoing patency and minimize complications, an appropriate self-expanding metal stent should ideally be placed. |
| first_indexed | 2024-04-12T21:56:46Z |
| format | Article |
| id | doaj.art-cd92158256884747a02d55254b31c45a |
| institution | Directory Open Access Journal |
| issn | 2213-1795 |
| language | English |
| last_indexed | 2024-04-12T21:56:46Z |
| publishDate | 2018-07-01 |
| publisher | Society of Gastrointestinal Intervention |
| record_format | Article |
| series | Gastrointestinal Intervention |
| spelling | doaj.art-cd92158256884747a02d55254b31c45a2022-12-22T03:15:18ZengSociety of Gastrointestinal InterventionGastrointestinal Intervention2213-17952018-07-0172677310.18528/gii180017gii180017Preoperative biliary drainage for pancreatic cancerOsman Ahmed0Jeffrey H. Lee1Department of Gastroenterology, Hepatology and Nutrition, University of Texas MD Anderson Cancer Center, Houston, TX, USADepartment of Gastroenterology, Hepatology and Nutrition, University of Texas MD Anderson Cancer Center, Houston, TX, USAPancreatic cancer is a leading cause of cancer-related morbidity and mortality, but any meaningful improvement in its prognosis remains elusive. The lack of early diagnostic methods means that many patients only present when symptoms develop, such as obstructive jaundice. Once a diagnosis of pancreatic cancer has been made in a patient with obstructive jaundice, then a decision should be made if the patient is a candidate for surgical resection. Patients who are candidates for surgical resection generally do not need preoperative biliary drainage, unless they present with cholangitis, or if they require neo-adjuvant chemotherapy. If preoperative biliary drainage is to be done, then patient factors and local expertise should guide appropriate interventions. The evidence for endoscopic retrograde cholangiopancreatography as a first-line therapy for biliary decompression is strong; However, the use of percutaneous transhepatic biliary drainage as well as endoscopic ultrasound-guided biliary drainage has generally not been found to be inferior. Finally, to ensure ongoing patency and minimize complications, an appropriate self-expanding metal stent should ideally be placed.https://doi.org/10.18528/gii180017EndoscopyObstructionPancreatic cancerUltrasound |
| spellingShingle | Osman Ahmed Jeffrey H. Lee Preoperative biliary drainage for pancreatic cancer Gastrointestinal Intervention Endoscopy Obstruction Pancreatic cancer Ultrasound |
| title | Preoperative biliary drainage for pancreatic cancer |
| title_full | Preoperative biliary drainage for pancreatic cancer |
| title_fullStr | Preoperative biliary drainage for pancreatic cancer |
| title_full_unstemmed | Preoperative biliary drainage for pancreatic cancer |
| title_short | Preoperative biliary drainage for pancreatic cancer |
| title_sort | preoperative biliary drainage for pancreatic cancer |
| topic | Endoscopy Obstruction Pancreatic cancer Ultrasound |
| url | https://doi.org/10.18528/gii180017 |
| work_keys_str_mv | AT osmanahmed preoperativebiliarydrainageforpancreaticcancer AT jeffreyhlee preoperativebiliarydrainageforpancreaticcancer |