Nakakura Eric K, Warren Robert S
Department of Surgery, Division of Surgical Oncology, University of California, UCSF Comprehensive Cancer Center, 1600 Divisadero Street, San Francisco, CA 94143-1932, USA.
Surg Oncol. 2007 Dec;16(4):293-7. doi: 10.1016/j.suronc.2007.08.003. Epub 2007 Sep 14.
Because most patients with pancreatic and biliary cancer have advanced disease, the palliation of debilitating symptoms is critically important in patient management. A multidisciplinary team consisting of representatives from surgery, medical oncology, gastroenterology, radiology, and palliative care medicine is essential for the optimal palliation of symptoms. In this article, the key issues in palliative care for patients with advanced pancreatic and biliary cancer are discussed. In particular, the prevention and amelioration of suffering due to obstructive jaundice, gastric outlet obstruction, cancer-related pain, pancreatic enzyme insufficiency, and thromboembolic disease is addressed. To this end, an algorithm for the multidisciplinary management of these challenging patients is proposed with the goal of providing clinicians with a useful framework for providing palliative care for patients with advanced pancreatic and biliary cancer.
由于大多数胰腺癌和胆管癌患者已处于疾病晚期，缓解使人虚弱的症状在患者管理中至关重要。一个由外科、医学肿瘤学、胃肠病学、放射学和姑息治疗医学代表组成的多学科团队对于症状的最佳缓解至关重要。在本文中，将讨论晚期胰腺癌和胆管癌患者姑息治疗中的关键问题。特别关注因梗阻性黄疸、胃出口梗阻、癌痛、胰酶缺乏和血栓栓塞性疾病导致的痛苦的预防和缓解。为此，提出了一种针对这些具有挑战性患者的多学科管理算法，目的是为临床医生提供一个有用的框架，以便为晚期胰腺癌和胆管癌患者提供姑息治疗。
