胰腺癌术前胆管引流指征和方式选择

Indications and methods of preoperative biliary drainage for pancreatic cancer

胰腺癌是高度恶性的肿瘤,手术是唯一可能的根治方法。其中部分胰头癌病人合并梗阻性黄疸,影响病人的肝功能、凝血等,对手术产生不良影响,需行术前胆管引流。但部分研究发现,术前胆管引流增加术后并发症发生风险。术前胆管引流指征、手术时机、引流方式等仍存在诸多争议,有待进一步研究。目前,应重视伴梗阻性黄疸的胰腺癌病人围手术期的管理,充分发挥多学科协作优势,提倡个体化治疗,以期进一步提高围手术期管理质量,改善病人预后。

Pancreatic cancer is a kind of highly malignant tumor and surgery is the only possible radical treatment.However,some patients with pancreatic head cancer will have obstructive jaundice.It will affect the liver function and blood coagulation,resulting in adverse effects on the operation.Therefore,preoperative biliary drainage is required.However,some studies have found that preoperative biliary drainage can lead to an increased risk of postoperative complications.Therefore,there are still many controversies including drainage indications,surgical timing,and drainage methods.For the pancreatic cancer patients with obstructive jaundice,more attention should be paid to the perioperative management,advantages of multidisciplinary collaboration should be fully utilized,and personalized treatment should be promoted.It will further improve the quality of perioperative complication management and the prognosis of patients.