title: Palliative Care for Pancreatic and Periampullary Cancer.
abstract: Most patients with pancreatic cancer will present with metastatic or locally advanced disease. Unfortunately, most patients with localized disease will experience recurrence even after multimodality therapy. As such, pancreatic cancer patients arrive at a common endpoint where decisions pertaining to palliative care come to the forefront. This article summarizes surgical, endoscopic, and other palliative techniques for relief of obstructive jaundice, relief of duodenal or gastric outlet obstruction, and relief of pain due to invasion of the celiac plexus. It also introduces the utility of the palliative care triangle in clarifying a patient's and family's goals to guide decision making.
authors.affiliation: Department of Surgery, The University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555, USA.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Perone
authors.affiliation: Department of Surgery, Banner-University Medical Center, University of Arizona, 1501 North Campbell Avenue, Tucson, AZ 85724, USA. Electronic address: tsriall@surgery.arizona.edu.
authors.forename: Taylor S
authors.initials: TS
authors.lastname: Riall
authors.affiliation: Department of Surgery, The University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555, USA.
authors.forename: Kelly
authors.initials: K
authors.lastname: Olino
mesh_terms: D014670:Ampulla of Vater; D006801:Humans; D009367:Neoplasm Staging; D010166:Palliative Care / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000628:therapy*
keywords: Biliary-enteric bypass; Celiac block; Endoscopic biliary stent; Gastric outlet obstruction; Obstructive jaundice; Palliative care; Palliative triangle; Supportive care