Abstract
There are many approaches to palliation of jaundice in patients with pancreatic cancer. Each stenting technique has merit. Regrettably, an insufficient number of randomized comparative trials using the latest technology have been performed. Moreover, economic analyses of techniques to aid in clinical decision making are few. Currently data support endoscopic stenting as the standard for most patients with obstructive jaundice from pancreatic cancer. Patients with an expected survival of more than 6 months should undergo placement of an expandable metal stent, whereas patients with a limited life expectancy (<3 months) are best served with a plastic stent. Randomized comparative studies are needed between laparoscopic techniques and endoscopically placed expandable metal stents. Percutaneous techniques may prove safer and more effective when metal expandable stents are used.
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