Unfortunately, most patients diagnosed with pancreatic cancer will succumb to their disease within a year or two of diagnosis. For those who are candidates for resection, recent data suggest they can expect a 5-year survival as high as 35%. Until a new method for early detection and substantially improved targeted treatment is developed, pancreatic cancer will remain a uniformly lethal condition. Patients who are not candidates for curative resection often require intervention to address complications associated with local tumor growth, to achieve improved quality of life, and to maximize the benefits of medical therapy.
Despite the fact that most pancreatic cancer patients are not candidates for surgical resection, the surgeon plays an important role in their management. A clear understanding of the interventionsavailable to mitigate the local effects of pancreatic cancer growth on the bile duct, duodenum, and celiac plexus helps to navigate the nonoperative and intraoperative approaches to palliate this group (Figure 7). When appropriate, nonoperative intervention should be the first line of treatment for unresectable patients. Biliary stenting, duodenal stenting, and percutaneous celiac plexus block are effective for palliation of patients with short life expectancies. Operative bypass can effectively address biliary and duodenal obstruction for patients who fail endoscopic therapy or who are identified as unresectable at the time of laparotomy or laparoscopy. Optimal palliation of these conditions improves quality of life, minimizes the need for hospitalization, and allows the patient to engage in palliative chemotherapy, thus maximizing survival benefit.
Yorumlar;Bbaslangic itibari ile ilk 2 yil icinde tanisi konursa , cerrahi Sonrasi 5 yillik yuzde 35 yasam sansi
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