Jupp James A, Johnson Colin D, Shek Fanny W, Fine David R
University of Southampton, School of Medicine, Southampton, UK.
University of Southampton and Southampton University Hospitals NHS Trust, Southampton, UK.
Frontline Gastroenterol. 2011 Apr;2(2):71-76. doi: 10.1136/fg.2009.000562. Epub 2011 Jan 9.
An integrated pancreatic disease unit needs to deliver high-quality care both to patients with malignant and non-malignant pancreatic disease. The regionalisation of pancreatic cancer services which followed the publication of policy frameworks by the Department of Health and NHS executive led to the development of disease-site-specialised high-volume multidisciplinary teams. As the majority of patients with pancreatic cancer are not suitable for surgery, partner hospitals within a region need to provide access to a wide range of non-surgical treatment. The implementation of such working may require pooling of local resources to create networks of equivalence to tertiary centres. The provision of care to non-malignant pancreatic disease can benefit from this type of working and services can be modelled on, and integrate with, cancer services. One way of achieving this is to establish working groups based upon diseases rather than traditional departments, which can deliver standardised and optimal care with a patient-centred approach. However, this poses a number of potential problems. This review examines how an integrated pancreatic unit may be developed in district general and larger hospitals, and also describes our experience in developing such a unit.
一个综合性胰腺疾病科室需要为患有恶性和非恶性胰腺疾病的患者提供高质量的护理。卫生部和国民保健服务体系行政部门发布政策框架后，胰腺癌服务的区域化促使了疾病部位专业化的高容量多学科团队的发展。由于大多数胰腺癌患者不适合手术，一个地区内的合作医院需要提供广泛的非手术治疗途径。实施这种工作方式可能需要集中当地资源，以建立与三级中心等效的网络。为非恶性胰腺疾病提供护理可以从这种工作方式中受益，并且服务可以以癌症服务为蓝本并与之整合。实现这一目标的一种方法是基于疾病而非传统科室建立工作组，该工作组可以采用以患者为中心的方法提供标准化和最佳护理。然而，这带来了一些潜在问题。本综述探讨了如何在地区综合医院和大型医院中建立综合性胰腺科室，并描述了我们在建立这样一个科室方面的经验。
