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首页> 外文期刊>Current opinion in gastroenterology >Endoscopic palliation of pancreatic adenocarcinoma.
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Endoscopic palliation of pancreatic adenocarcinoma.

机译：内镜对胰腺腺癌的缓解。

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摘要

PURPOSE OF REVIEW: Endoscopic therapies have become an indispensable modality in the treatment and palliation of complications from pancreatic adenocarcinoma. This review focuses on treatment of biliary obstruction, malignant gastric outlet obstruction, and intractable abdominal pain resulting from unresectable pancreatic adenocarcinoma. Novel and emerging endoscopic approaches are also briefly discussed. RECENT FINDINGS: Endoscopic placement of a biliary stent is the modality of choice for palliation of biliary obstruction. Biliary self-expanding metal stents should be placed if expected survival is more than 6 months and plastic stents if expected survival is less than 6 months. For endoscopic palliation of gastric outlet obstruction, enteral self-expanding metal stents should be placed. Biliary self-expanding metal stents should be considered prior to the placement of a duodenal stent. Palliation of intractable abdominal pain can safely be performed with endoscopic ultrasound-guided celiac plexus neurolysis using bupivacaine and absolute alcohol. Exciting novel endoscopic approaches are being evaluated especially in the area of drug-eluted biliary stents, endoscopic creations of enteral anastomoses, and endoscopic ultrasound-guided injection of gene vectors. SUMMARY: The frontier of endoscopic palliative therapies for pancreatic adenocarcinoma is expanding. Clinical trials are needed to evaluate novel endoscopic approaches.
机译：审查的目的：内窥镜治疗已成为治疗和缓解胰腺腺癌并发症的必不可少的方法。这篇综述的重点是不可切除的胰腺腺癌引起的胆道梗阻，恶性胃出口梗阻和顽固性腹痛的治疗。还简要讨论了新颖和新兴的内窥镜检查方法。最新发现：内镜下胆道支架置入术是缓解胆道梗阻的一种选择方式。如果预期生存期超过6个月，则应放置胆自膨胀金属支架，如果预期生存期少于6个月，则应放置塑料支架。为内镜缓解胃出口梗阻，应放置肠自扩张金属支架。在放置十二指肠支架之前，应考虑胆自扩张金属支架。使用布比卡因和无水酒精在内镜超声引导下的腹腔神经丛神经溶解术可以安全地治疗顽固性腹痛。令人兴奋的新型内窥镜检查方法正在评估中，尤其是在药物洗脱胆道支架，内窥镜下建立肠吻合术以及内窥镜超声引导下注射基因载体方面。摘要：内镜姑息治疗胰腺腺癌的领域正在扩大。需要临床试验来评估新型内窥镜检查方法。

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