La palliazione endoscopica dell’ittero ostruttivo da carcinoma inoperabile del pancreas. Nostra esperienza


COD: 473-476 Categorie: ,

Girolamo Geraci, Carmelo Sciumè, Franco Pisello, Francesco Li Volsi, Tiziana Facella, Giuseppe Modica

Ann. Ital. Chir., 2005; 76: 473-476

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AIM OF THE STUDY: Few patients with pancreatic cancer are eligible for resection. In the remainder, estimation of prognosis
is important to optimise various aspects of care, including palliation of biliary obstruction and trial of chemotherapy.
The aim is to refer our personal experience about the palliation with endoscopic stenting in patients with unresectable
pancreatic cancer.
METHODS: The Authors reviewed retrospectively 132 patients affected by unresectable pancreatic cancer who underwent
palliative interventions with endoscopic stenting from 2000 to 2004.
RESULTS: Jaundice dramatically decreased in 86% of patients within 36 hours, in 12% within 48 hours and in 2%
after two days.
As complication were registered 3% of bleeding after endoscopic sphyncterotomy, 2% mild acute pancreatitis after-ERCP
and in 7% of patients transitory hyperamylasemia.
The most frequent late complication was relapse of jaundice or cholangitis for stent clogging (51%) in a variable range
from 72.3 to 120.7 days, treated with stent substitution.
No mortality ERCP-related was registered.
CONCLUSION: Resection offers the only potentially curative approach to pancreatic cancer. The majority of patients are
either too old, too ill with coexistent disease, or have a tumour that is undoubtedly inappropriate to resect. Thus for
the vast majority an endoprosthesis to relieve the jaundice, is the preferred management, after a multidisciplinary approach.