恶性胆道梗阻的评估和管理。

Evaluation and Management of Malignant Biliary Obstruction.

机构信息

Department of Surgery, University of New Mexico School of Medicine, 2425 Camino de Salud, Albuquerque, NM 87106, USA.

Department of Surgery, Division of Trauma Surgery, University of New Mexico; Division of Palliative Medicine, University of New Mexico, Albuquerque, NM, USA.

出版信息

Surg Oncol Clin N Am. 2021 Jul;30(3):491-503. doi: 10.1016/j.soc.2021.03.001.

DOI:10.1016/j.soc.2021.03.001

PMID:34053664

Abstract

There is no reason to be pollyannaish when approaching patients with malignant biliary obstruction (MBO). Although technology has allowed refining diagnosis and resectability of cancers causing biliary obstruction, outcomes have not improved significantly. The previous preponderant place of surgical procedures now is replaced by endoluminal and percutaneous techniques for the management of symptoms of MBO. Because quantity of life often is the primary and sole outcome for evaluation of various interventions, the main focus of patient quality of life may be erroneously deemphasized. Lagging behind scientific advances are the availability of palliative care services and studies of patient-related outcomes.

摘要

在面对恶性胆道梗阻 (MBO) 患者时，没有理由盲目乐观。尽管技术已经允许对导致胆道梗阻的癌症进行更精确的诊断和可切除性评估，但结果并没有显著改善。以前，外科手术在治疗 MBO 症状方面占据主导地位，现在则被内镜和经皮技术所取代。由于生命数量通常是评估各种干预措施的主要和唯一结果，因此患者生活质量的主要关注点可能被错误地淡化了。在姑息治疗服务的可用性和患者相关结果的研究方面，落后于科学进步。