Baumel H, Huguier M, Fabre J M
Service de Chirurgie Digestive C, Hôpital Saint-Eloi, Montpellier.
Ann Chir. 1995;49(2):110-5; discussion 116-20.
Cancers of the head of the pancreas are only resectable in 10 to 25% of cases. The majority of patients are therefore candidates for a palliative treatment jaundice, pain or upper gastro-intestinal obstruction. Palliative surgical bypasses offer a durable efficiency for patients with a relatively short-term life expectancy. Endoscopic placement of biliary stents for jaundice is an alternative but leads to frequent complications and does not act on other clinical symptoms. Controlled trials did not show any statistical difference between surgical or endoscopic treatments. We only recommend endoscopic procedures for patients unfit for surgery with poor general status or distant metastases.
胰腺头部癌仅在10%至25%的病例中可切除。因此，大多数患者适合接受姑息治疗，以缓解黄疸、疼痛或上消化道梗阻。姑息性手术旁路对预期寿命相对较短的患者具有持久的疗效。内镜下放置胆管支架治疗黄疸是一种替代方法，但会导致频繁的并发症，且对其他临床症状无效。对照试验未显示手术治疗和内镜治疗之间存在任何统计学差异。我们仅推荐对因全身状况差或有远处转移而不适合手术的患者采用内镜治疗。
