Details

Autor(en) / Beteiligte

• van der Gaag, Niels A
• Rauws, Erik A.J
• van Eijck, Casper H.J
• Bruno, Marco J
• van der Harst, Erwin
• Kubben, Frank J.G.M
• Gerritsen, Josephus J.G.M
• Greve, Jan Willem
• Gerhards, Michael F
• de Hingh, Ignace H.J.T
• Klinkenbijl, Jean H
• Nio, Chung Y
• de Castro, Steve M.M
• Busch, Olivier R.C
• van Gulik, Thomas M
• Bossuyt, Patrick M.M
• Gouma, Dirk J

Titel

Preoperative Biliary Drainage for Cancer of the Head of the Pancreas

Ist Teil von

• The New England journal of medicine, 2010-01, Vol.362 (2), p.129-137

Ort / Verlag

Waltham, MA: Massachusetts Medical Society

Erscheinungsjahr

2010

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• Preoperative biliary drainage is often performed in patients with obstructive jaundice caused by cancer of the pancreatic head, but the benefit of the procedure is unclear. This randomized trial compared 4 to 6 weeks of preoperative biliary drainage, followed by surgery, with immediate surgery alone for cancer of the pancreatic head. The drainage procedure increased morbidity and did not decrease the rate of surgical complications. This randomized trial compared 4 to 6 weeks of preoperative biliary drainage, followed by surgery, with immediate surgery alone for cancer of the pancreatic head. The drainage procedure increased morbidity and did not decrease the rate of surgical complications. Obstructive jaundice is the most common symptom in patients with periampullary cancer (located near the ampulla of Vater) or cancer of the pancreatic head. For patients with a resectable tumor who have no radiologic evidence of metastasis, surgical resection is the only option for cure. 1 – 3 Since surgery in patients with jaundice is thought to increase the risk of postoperative complications, preoperative biliary drainage was introduced to improve the postoperative outcome. 4 In several experimental studies and retrospective case series, preoperative biliary drainage reduced morbidity and mortality after surgery. 4 – 7 However, two meta-analyses of randomized trials and a systematic review of . . .