Olgyai Gábor, Oláh Attila
Petz Aladár Megyei Oktató Kórház Sebészeti Osztály, 9024 Gyor, Vasvári P. u. 2-4.
Magy Seb. 2007 Oct;60(5):239-42. doi: 10.1556/MaSeb.60.2007.5.2.
This review summarises the data of current meta-analyses on the outcome of endoscopic and surgical biliary bypass procedures applied for inoperable pancreatic tumours. The authors suggest that plastic biliary stents should be used in cases only with short survival (less than six months). In patients with a prognosis of longer than six month, self-expandable metal stents are more cost-effective. This latter technique is as efficient as the traditional surgical bypass procedures. However, surgical bypass is preferable in cases if tumour resection is questionable after staging or in patients with gastric emptying problems.Furthermore, application of duodenal stents is suggested in selected cases only due to relatively frequent late complications (stent migration, perforation, obstruction). Duodenal stents can be used in patients with advanced stage disease or very high operative risk.
本综述总结了当前关于应用于不可切除胰腺肿瘤的内镜和外科胆道旁路手术结果的荟萃分析数据。作者建议，仅在生存期较短（少于6个月）的病例中使用塑料胆道支架。对于预后超过6个月的患者，自膨式金属支架更具成本效益。后一种技术与传统外科旁路手术一样有效。然而，如果分期后肿瘤切除存在疑问或患者有胃排空问题，外科旁路手术更可取。此外，仅在特定病例中建议应用十二指肠支架，因为其晚期并发症（支架移位、穿孔、梗阻）相对频繁。十二指肠支架可用于晚期疾病患者或手术风险非常高的患者。
