The Christie NHS Foundation Trust, Manchester, Greater Manchester, UK.
Department of Gastroenterology, Manchester Royal Infirmary, Manchester, UK.
J Gastrointest Cancer. 2022 Dec;53(4):1050-1065. doi: 10.1007/s12029-021-00718-7. Epub 2021 Oct 14.
Management of pancreaticobiliary (PB) malignancies remains a clinical challenge. In this review, we focus on the management of oncological emergencies in PB malignancies and the potential complication of associated therapeutic interventions.
Biobliographic review of current evidence on the management of oncological emergencies, their potential complications, as well as synthesis of recommendations was performed. The pathogenesis, frequency, related symptoms as well as appropriate investigations are presented.
The oncologic emergencies in PB patients were summarised in six categories: (1) hematological (including febrile neutropaenia, thrombocytopenia, coagulopathies), (2) gastrointestinal (gastric outlet and biliary obstruction, gastrointestinal bleeding), (3) thromboembolic events, (4) ascites, (5) metabolic disorders and (6) neurologic complications. The pathogenesis, frequency, related symptoms as well as appropriate investigations are also presented.
Patients with PB malignancies are at increased risk of a wide variation of medical emergencies. Clinical knowledge, early recognition and collaboration with the relevant specialties are critical to manage these complications effectively, tailoring overall management around the actual prognosis and individuals' expectations.
胰腺肝胆（PB）恶性肿瘤的治疗仍然是临床挑战。在本综述中，我们专注于 PB 恶性肿瘤的肿瘤急症管理以及相关治疗干预的潜在并发症。
对目前关于肿瘤急症管理、其潜在并发症以及建议综合的文献进行生物医学综述。介绍了发病机制、频率、相关症状以及适当的检查。
总结了 PB 患者的肿瘤急症有以下六类：（1）血液学（包括发热性中性粒细胞减少症、血小板减少症、凝血功能障碍）；（2）胃肠道（胃出口和胆道梗阻、胃肠道出血）；（3）血栓栓塞事件；（4）腹水；（5）代谢紊乱；（6）神经并发症。还介绍了发病机制、频率、相关症状以及适当的检查。
PB 恶性肿瘤患者发生各种医疗急症的风险增加。临床知识、早期识别以及与相关专业的合作对于有效管理这些并发症至关重要，根据实际预后和个体预期来调整整体管理。
