Palliative Care for Pancreatic and Periampullary Cancer

Perone, Jean‐Marc; Riall, Taylor S.; Olino, Kelly

doi:10.1016/j.suc.2016.07.012

Cited by 56 publications

(47 citation statements)

References 58 publications

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“…Common indications for palliative procedures in pancreatic cancer are gastric outlet obstructions and obstructive jaundice, both of which can be intervened upon by operative and endoscopic approaches, complicating the cost analysis . Roy et al performed a retrospective review of Medicare's MedPAR database, identifying 774 patients who underwent intervention for gastric outlet obstruction due to pancreaticobiliary obstructions from 2007‐2008 .…”

Section: Costmentioning

confidence: 99%

Patient selection in palliative surgery: Defining value

Cohen

2019

Journal of Surgical Oncology

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Proper patient selection for palliative surgery requires a challenging and often complex decision-making process. Optimally, proposed palliative procedures must be undertaken with an intent to provide the greatest possible value to patients at the end of life. This review describes the process of patient selection and identifies psychosocial, biochemical, and functional markers that can complement sound surgical judgment.impact, palliative surgery, patient selection, value

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Section: Costmentioning

confidence: 99%

Patient selection in palliative surgery: Defining value

Cohen

2019

Journal of Surgical Oncology

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“…Malignant obstructive jaundice is the most common presentation and its management can be complex [1,2]. In patients who do not qualify for surgical treatment, palliative biliary tract drainage must be considered as it improves quality of life and prevents associated complications, such as cholangitis, pruritus, nausea, and anorexia [3,4]. The preferred procedure to relieve biliary obstruction is endoscopic retrograde cholangiopancreatography (ERCP) with stent placement, with a success rate of 90% [5].…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Ultrasound-Guided Choledochoduodenostomy as Palliative Treatment: A Challenging Case Report

Ribeiro¹,

Azevedo²,

Caldeira³

et al. 2017

GE Port J Gastroenterol

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We report the case of an 88-year-old female with obstructive jaundice due to a periampullary tumor. The patient developed acute cholangitis and consequent clinical deterioration, so it was decided to perform palliative biliary drainage. Due to duodenal tumor invasion, it was not possible to perform endoscopic retrograde cholangiopancreatography. A different approach was attempted and it was decided to carry out an endoscopic ultrasound-guided choledochoduodenostomy. This procedure was performed with a linear echoendoscope, and using a duodenal bulbar approach, a fistula was created between the bulb and the common bile duct. A self-expandable fully covered metal biliary stent was placed in the common bile duct under endoscopic and fluoroscopic guidance, allowing biliary drainage. The patient presented clinical improvement. However, 3 weeks after being discharged, she was readmitted to our department with hematemesis associated with the migration of the biliary stent to the duodenal bulb. Endoscopic hemostasis was performed but the patient had multiple bleeding relapses that were controlled through arterial embolization. Despite the migration of the biliary stent, the fistula between the duodenum and the common bile duct remained patent, allowing a successful palliation of the obstructive jaundice. Therefore, despite the occurred complication, we admitted a technical and clinical success of the endoscopic ultrasound-guided choledochoduodenostomy. This is an emerging technique and a valuable alternative for palliative biliary drainage in cases of malignant distal obstruction. This clinical report supports this finding, reporting technical aspects of the procedure, associated complications and their management as well as the clinical outcomes.

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“…Thus, chemokines play a key role in the interaction of nerves and cancer cells. In addition, pancreatic neuropathy is characterized by numerous molecular and morphological changes in peripheral and central nervous systems [28].…”

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confidence: 99%

“…An increase in peripheral nociceptive signals is mediated by neurotransmitters and neurotrophic factors, along with the damage to nerves and neuroplasticity changes in the neurons of dorsal horns of the spinal cord [28].…”

mentioning

confidence: 99%

Chronic pain syndrome in patients with pancreatic cancer: individual therapy and its pathogenetic background

Боброва¹,

Shnayder²,

Dychno³

et al. 2019

Russ Open Med J

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This review presents the results of recent studies on the role of pathogenic mechanisms of chronic pain syndrome in patients with pancreatic cancer. The authors searched Russian and international databases, including MedLine, PubMed, NEL elibrary.ru, Wiley Online Library, Web of Science, Oxford University Press, SAGE Premier, for the period from 1996 to 2016 (10 years). Our results demonstrate the preconditions for multimodal analgesic therapy in anesthesia and pain treatment. We show the key role of selecting basic pharmacological groups of drugs for the patients with pancreatic cancer with chronic pain syndrome. The dependence of patient survival on the intensity, diversity and complexity of pancreatic pain in pancreatic cancer means that individual therapy is extremely important as inadequate pain relief can have profound negative effects on the psychosocial and physical well-being of pancreatic cancer patients and their relatives.

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Palliative Care for Pancreatic and Periampullary Cancer

Cited by 56 publications

References 58 publications

Patient selection in palliative surgery: Defining value

Patient selection in palliative surgery: Defining value

Endoscopic Ultrasound-Guided Choledochoduodenostomy as Palliative Treatment: A Challenging Case Report

Chronic pain syndrome in patients with pancreatic cancer: individual therapy and its pathogenetic background

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