title: Integrating medical and surgical treatments in gastrointestinal, genitourinary, and biliary obstruction in patients with cancer.
abstract: Although local expertise needs to be considered, the following general guidelines for the palliation of malignant biliary obstruction have been proposed: (1) patients in good general condition with small tumors should undergo laparotomy to assess resectability and undergo surgical bypass; (2) patients with advanced disease and poor general condition are suitable for endoscopic stenting to reduce jaundice, pruritus, and risk of cholangitis; (3) patients with poor cognition and limited life expectancy should be managed pharmacologically as appropriate; and (4) research is required to assess optimal management for patients between these extremes; however, clinicians can use the previously described guidelines to make these difficult management decisions.
authors.affiliation: Palliative Care Program, Royal Alexandra Hospital, Edmonton, Alberta, Canada.
authors.forename: R L
authors.initials: RL
authors.lastname: Fainsinger
mesh_terms: D002779:Cholestasis / Q000150:complications / Q000601:surgery / Q000628:therapy*; D003131:Combined Modality Therapy; D006801:Humans; D007415:Intestinal Obstruction / Q000150:complications / Q000601:surgery / Q000628:therapy*; D009369:Neoplasms / Q000150:complications*; D014517:Ureteral Obstruction / Q000150:complications / Q000601:surgery / Q000628:therapy*