Original articleClinical endoscopyEfficacy and safety of self-expandable metal stents for biliary decompression in patients receiving neoadjuvant therapy for pancreatic cancer: a prospective study
Section snippets
Patients and methods
This study was conducted at one tertiary-care medical center where all patients with resectable or potentially resectable pancreatic cancer receive neoadjuvant therapy and are managed with a multidisciplinary approach. All patients provided written informed consent for endoscopic and surgical procedures as well as neoadjuvant therapy. The study was approved by the Medical College of Wisconsin institutional review board.
From March 2009 to December 2010, all patients with proven pancreatic
Results
Over a 22-month period, a total of 55 consecutive patients (29 men, 26 women; mean [± SD] age 65.9 ± 11 years) with pancreatic cancer and biliary obstruction had SEMSs placed to relieve biliary occlusion, and all of these patients underwent neoadjuvant therapy. Of the 55 patients, 33 (60%) had undergone ERCP at an outside hospital and presented with a plastic stent in place (Table 2). The majority of these plastic stents (90%) were 10F in diameter. The median duration for which the plastic
Discussion
In 2012, it is estimated that 43,920 new cases of pancreatic cancer will be diagnosed in the United States, and 37,390 will die from the disease.17 Surgical resection is the only chance for cure. Obstructive jaundice develops in up to 77% of patients with cancer of the head of the pancreas.18 However, because spontaneous cholangitis is rare with malignant biliary obstruction (unless the bile duct is contaminated with interventions), biliary drainage may not be necessary in those going for early
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DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
See CME section; p. 159.