| Title |
Endoscopic Palliation of Pancreatic Cancer
|
|---|---|
| Published in |
Current Treatment Options in Gastroenterology, August 2017
|
| DOI | 10.1007/s11938-017-0145-z |
| Pubmed ID | |
| Authors |
Vishal B. Gohil, Jason B. Klapman |
| Abstract |
Pancreas cancer is a fourth-leading cause of cancer death in the USA and its incidence is rising as the population is aging. The majority of patients present at an advanced stage due to the silent nature of the disease and treatment have focused more on palliation than curative intent. Gastroenterologists have become integral in the multidisciplinary care of these patients with a focus on providing endoscopic palliation of pancreas cancer. The three most common areas that gastroenterologists palliate endoscopically are biliary obstruction, cancer-related pain, and gastric outlet obstruction. To palliate biliary obstruction, the procedure of choice is to perform endoscopic retrograde cholangiopancreatography (ERCP) with biliary stent placement. We tend to place covered self-expandable metal stents (SEMS) due to their longer patency and removability unless the patient has resectable disease. Pancreas cancer pain is a result of tumor infiltration of the celiac plexus and can be severe and poorly responsive to narcotics. To improve pain control, neurolysis of the celiac plexus has been performed for decades. Since 1996, neurolysis of the celiac area has been performed endoscopically by Endoscopic Ultrasound-Guided Celiac Plexus Neurolysis. This has proven to be as safe and effective as traditional non-endoscopic methods and has allowed the patients to decrease their narcotic use and improve their pain control. This should be done early on in the course of the disease to have maximal effect. Gastric outlet obstruction (GOO) occurs in approximately 15-20% of patients with pancreas cancer. Endoscopic palliation of GOO can be performed by placing uncovered metal enteral stents across the obstruction. This procedure has proven to be very effective in patients who have a short life expectancy (less than two to 6 months) while surgical bypass should be considered for patients with longer life expectancies because it offers better long-term symptom relief. This chapter will review the current literature, latest advancements, and optimal techniques for endoscopic palliation of pancreatic cancer. |
Mendeley readers
The data shown below were compiled from readership statistics for 6 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 1 | 17% |
| Brazil | 1 | 17% |
| Unknown | 4 | 67% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Doctoral Student | 6 | 100% |
| Researcher | 5 | 83% |
| Other | 5 | 83% |
| Professor > Associate Professor | 5 | 83% |
| Student > Postgraduate | 4 | 67% |
| Other | 9 | 150% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 27 | 450% |
| Psychology | 3 | 50% |
| Biochemistry, Genetics and Molecular Biology | 1 | 17% |
| Immunology and Microbiology | 1 | 17% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 17% |
| Other | 0 | 0% |
Attention Score in Context
This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 November 2021.
All research outputs
#8,882,501
of 26,017,215 outputs
Outputs from Current Treatment Options in Gastroenterology
#95
of 295 outputs
Outputs of similar age
#129,262
of 331,332 outputs
Outputs of similar age from Current Treatment Options in Gastroenterology
#6
of 9 outputs
Altmetric has tracked 26,017,215 research outputs across all sources so far. This one is in the 42nd percentile – i.e., 42% of other outputs scored the same or lower than it.
So far Altmetric has tracked 295 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.1. This one is in the 48th percentile – i.e., 48% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 331,332 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 51% of its contemporaries.
We're also able to compare this research output to 9 others from the same source and published within six weeks on either side of this one. This one has scored higher than 3 of them.