Pancreaticobiliary Malignancies in the Emergency Room: Management of Acute Complications and Oncological Emergencies.
Cholangiocarcinoma
Complications
Emergencies
Gall bladder cancer
Management
Pancreatic cancer
Journal
Journal of gastrointestinal cancer
ISSN: 1941-6636
Titre abrégé: J Gastrointest Cancer
Pays: United States
ID NLM: 101479627
Informations de publication
Date de publication:
Dec 2022
Dec 2022
Historique:
accepted:
22
09
2021
pubmed:
15
10
2021
medline:
5
11
2022
entrez:
14
10
2021
Statut:
ppublish
Résumé
Management of pancreaticobiliary (PB) malignancies remains a clinical challenge. In this review, we focus on the management of oncological emergencies in PB malignancies and the potential complication of associated therapeutic interventions. Biobliographic review of current evidence on the management of oncological emergencies, their potential complications, as well as synthesis of recommendations was performed. The pathogenesis, frequency, related symptoms as well as appropriate investigations are presented. The oncologic emergencies in PB patients were summarised in six categories: (1) hematological (including febrile neutropaenia, thrombocytopenia, coagulopathies), (2) gastrointestinal (gastric outlet and biliary obstruction, gastrointestinal bleeding), (3) thromboembolic events, (4) ascites, (5) metabolic disorders and (6) neurologic complications. The pathogenesis, frequency, related symptoms as well as appropriate investigations are also presented. Patients with PB malignancies are at increased risk of a wide variation of medical emergencies. Clinical knowledge, early recognition and collaboration with the relevant specialties are critical to manage these complications effectively, tailoring overall management around the actual prognosis and individuals' expectations.
Sections du résumé
BACKGROUND
BACKGROUND
Management of pancreaticobiliary (PB) malignancies remains a clinical challenge. In this review, we focus on the management of oncological emergencies in PB malignancies and the potential complication of associated therapeutic interventions.
METHODS
METHODS
Biobliographic review of current evidence on the management of oncological emergencies, their potential complications, as well as synthesis of recommendations was performed. The pathogenesis, frequency, related symptoms as well as appropriate investigations are presented.
RESULTS
RESULTS
The oncologic emergencies in PB patients were summarised in six categories: (1) hematological (including febrile neutropaenia, thrombocytopenia, coagulopathies), (2) gastrointestinal (gastric outlet and biliary obstruction, gastrointestinal bleeding), (3) thromboembolic events, (4) ascites, (5) metabolic disorders and (6) neurologic complications. The pathogenesis, frequency, related symptoms as well as appropriate investigations are also presented.
CONCLUSION
CONCLUSIONS
Patients with PB malignancies are at increased risk of a wide variation of medical emergencies. Clinical knowledge, early recognition and collaboration with the relevant specialties are critical to manage these complications effectively, tailoring overall management around the actual prognosis and individuals' expectations.
Identifiants
pubmed: 34648136
doi: 10.1007/s12029-021-00718-7
pii: 10.1007/s12029-021-00718-7
pmc: PMC9630225
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1050-1065Informations de copyright
© 2021. The Author(s).
Références
Lambert A, Schwarz L, Borbath I, Henry A, Van Laethem J-L, Malka D, et al. An update on treatment options for pancreatic adenocarcinoma. Ther Adv Med Oncol. 2019;11:175883591987556. https://doi.org/10.1177/1758835919875568 .
doi: 10.1177/1758835919875568
Klastersky J, de Naurois J, Rolston K, Rapoport B, Maschmeyer G, Aapro M, et al. Management of febrile neutropaenia: ESMO Clinical Practice Guidelines. Ann Oncol . 2016;27:v111–8. https://doi.org/10.1093/annonc/mdw325 .
doi: 10.1093/annonc/mdw325
Klastersky J, Paesmans M, Rubenstein EB, Boyer M, Elting L, Feld R, et al. The multinational association for supportive care in cancer risk index: a multinational scoring system for identifying low-risk febrile neutropenic cancer patients. J Clin Oncol. 2000;18:3038–51. https://doi.org/10.1200/JCO.2000.18.16.3038 .
doi: 10.1200/JCO.2000.18.16.3038
pubmed: 10944139
Conroy T, Desseigne F, Ychou M, Bouché O, Guimbaud R, Bécouarn Y, et al. FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med. 2011;364:1817–25. https://doi.org/10.1056/NEJMoa1011923 .
doi: 10.1056/NEJMoa1011923
pubmed: 21561347
Valle J, Wasan H, Palmer DH, Cunningham D, Anthoney A, Maraveyas A, et al. Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer. N Engl J Med. 2010;362:1273–81. https://doi.org/10.1056/NEJMoa0908721 .
doi: 10.1056/NEJMoa0908721
pubmed: 20375404
Flowers CR, Seidenfeld J, Bow EJ, Karten C, Gleason C, Hawley DK, et al. Antimicrobial prophylaxis and outpatient management of fever and neutropenia in adults treated for malignancy: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol. 2013;31:794–810. https://doi.org/10.1200/JCO.2012.45.8661 .
doi: 10.1200/JCO.2012.45.8661
pubmed: 23319691
Kern WV, Marchetti O, Drgona L, Akan H, Aoun M, Akova M, et al. Oral antibiotics for fever in low-risk neutropenic patients with cancer: a double-blind, randomized, multicenter trial comparing single daily moxifloxacin with twice daily ciprofloxacin plus amoxicillin/clavulanic acid combination therapy—EORTC infectious. J Clin Oncol. 2013;31:1149–56. https://doi.org/10.1200/JCO.2012.45.8109 .
doi: 10.1200/JCO.2012.45.8109
pubmed: 23358983
Mhaskar R, Clark OAC, Lyman G, Engel Ayer Botrel T, Morganti Paladini L, Djulbegovic B. Colony-stimulating factors for chemotherapy-induced febrile neutropenia. Cochrane Database Syst Rev 2014. https://doi.org/10.1002/14651858.CD003039.pub2 .
Okusaka T, Nakachi K, Fukutomi A, Mizuno N, Ohkawa S, Funakoshi A, et al. Gemcitabine alone or in combination with cisplatin in patients with biliary tract cancer: a comparative multicentre study in Japan. Br J Cancer. 2010;103:469–74. https://doi.org/10.1038/sj.bjc.6605779 .
doi: 10.1038/sj.bjc.6605779
pubmed: 20628385
pmcid: 2939781
Von Hoff DD, Ervin T, Arena FP, Chiorean EG, Infante J, Moore M, et al. Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine. N Engl J Med. 2013;369:1691–703. https://doi.org/10.1056/NEJMoa1304369 .
doi: 10.1056/NEJMoa1304369
Estcourt LJ, Birchall J, Allard S, Bassey SJ, Hersey P, Kerr JP, et al. Guidelines for the use of platelet transfusions. Br J Haematol. 2017;176:365–94. https://doi.org/10.1111/bjh.14423 .
doi: 10.1111/bjh.14423
pubmed: 28009056
Shinagare AB, Guo M, Hatabu H, Krajewski KM, Andriole K, Van Den Abbeele AD, et al. Incidence of pulmonary embolism in oncologic outpatients at a tertiary cancer center. Cancer. 2011;117:3860–6. https://doi.org/10.1002/cncr.25941 .
doi: 10.1002/cncr.25941
pubmed: 21319153
Jara-Palomares L, van Es N, Praena-Fernandez JMM, Le Gal G, Otten HMM, Robin P, et al. Relationship between type of unprovoked venous thromboembolism and cancer location: An individual patient data meta-analysis. Thromb Res. 2019;176:79–84. https://doi.org/10.1016/j.thromres.2019.02.011 .
doi: 10.1016/j.thromres.2019.02.011
pubmed: 30780008
Larsen AC, Brøndum Frøkjaer J, Wishwanath Iyer V, Vincents Fisker R, Sall M, Yilmaz MK, et al. Venous thrombosis in pancreaticobiliary tract cancer: outcome and prognostic factors. J Thromb Haemost. 2015;13:555–62. https://doi.org/10.1111/jth.12843 .
doi: 10.1111/jth.12843
pubmed: 25594256
Bonnerot M, Humbertjean L, Mione G, Lacour J-CC, Derelle A-LL, Sanchez J-CC, et al. Cerebral ischemic events in patients with pancreatic cancer. Medicine (Baltimore) 2016;95:e4009. https://doi.org/10.1097/MD.0000000000004009 .
Long B, Koyfman A. Oncologic emergencies: too much clotting—venous thromboembolism in malignancy. J Emerg Med. 2019;57:825–35. https://doi.org/10.1016/j.jemermed.2019.08.010 .
doi: 10.1016/j.jemermed.2019.08.010
pubmed: 31627886
Guilabert JP, Manzur DN, Tarrasa MJT, Llorens ML, Braun P, Arques MPB. Can multislice CT alone rule out reliably pulmonary embolism? A prospective study Eur J Radiol. 2007;62:220–6. https://doi.org/10.1016/j.ejrad.2006.11.032 .
doi: 10.1016/j.ejrad.2006.11.032
pubmed: 17236735
Campello E, Ilich A, Simioni P, Key NS. The relationship between pancreatic cancer and hypercoagulability: a comprehensive review on epidemiological and biological issues. Br J Cancer. 2019;121:359–71. https://doi.org/10.1038/s41416-019-0510-x .
doi: 10.1038/s41416-019-0510-x
pubmed: 31327867
pmcid: 6738049
Obulkasim H, Shi X, Wang J, Li J, Dai B, Wu P, et al. Podoplanin is an important stromal prognostic marker in perihilar cholangiocarcinoma. Oncol Lett. 2018;15:137–46. https://doi.org/10.3892/ol.2017.7335 .
doi: 10.3892/ol.2017.7335
pubmed: 29391878
Demers M, Wagner D. NETosis: a new factor in tumor progression and cancer-associated thrombosis. Semin Thromb Hemost. 2014;40:277–83. https://doi.org/10.1055/s-0034-1370765 .
doi: 10.1055/s-0034-1370765
pubmed: 24590420
pmcid: 4112728
Moik F, van Es N, Posch F, Di Nisio M, Fuereder T, Preusser M, et al. Gemcitabine and platinum-based agents for the prediction of cancer-associated venous thromboembolism: results from the Vienna Cancer and Thrombosis Study. Cancers (Basel). 2020;12:2493. https://doi.org/10.3390/cancers12092493 .
doi: 10.3390/cancers12092493
Aw A, Carrier M, Koczerginski J, McDiarmid S, Tay J. Incidence and predictive factors of symptomatic thrombosis related to peripherally inserted central catheters in chemotherapy patients. Thromb Res. 2012;130:323–6. https://doi.org/10.1016/j.thromres.2012.02.048 .
doi: 10.1016/j.thromres.2012.02.048
pubmed: 22444157
Brenner B, Hull R, Arya R, Beyer-Westendorf J, Douketis J, Elalamy I, et al. Evaluation of unmet clinical needs in prophylaxis and treatment of venous thromboembolism in high-risk patient groups: cancer and critically ill. Thromb J. 2019;17:6. https://doi.org/10.1186/s12959-019-0196-6 .
doi: 10.1186/s12959-019-0196-6
pubmed: 31011294
pmcid: 6466798
Khorana AA, McCrae KR, Milentijevic D, Fortier J, Nelson WW, Laliberté F, et al. Duration of anticoagulant therapy and VTE recurrence in patients with cancer. Support Care Cancer. 2019;27:3833–40. https://doi.org/10.1007/s00520-019-4661-3 .
doi: 10.1007/s00520-019-4661-3
pubmed: 30734088
pmcid: 6726708
Raskob GE, van Es N, Verhamme P, Carrier M, Di Nisio M, Garcia D, et al. Edoxaban for the treatment of cancer-associated venous thromboembolism. N Engl J Med. 2018;378:615–24. https://doi.org/10.1056/nejmoa1711948 .
doi: 10.1056/nejmoa1711948
pubmed: 29231094
Marshall A, Levine M, Hill C, Hale D, Thirlwall J, Wilkie V, et al. Treatment of cancer-associated venous thromboembolism: 12-month outcomes of the placebo versus rivaroxaban randomization of the SELECT-D Trial (SELECT-D: 12m). J Thromb Haemost. 2020;18:905–15. https://doi.org/10.1111/jth.14752 .
doi: 10.1111/jth.14752
pubmed: 31995662
Agnelli G, Becattini C, Meyer G, Muñoz A, Huisman MV, Connors JM, et al. Apixaban for the treatment of venous thromboembolism associated with cancer. N Engl J Med. 2020;382:1599–607. https://doi.org/10.1056/nejmoa1915103 .
doi: 10.1056/nejmoa1915103
pubmed: 32223112
Carrier M, Abou-Nassar K, Mallick R, Tagalakis V, Shivakumar S, Schattner A, et al. Apixaban to prevent venous thromboembolism in patients with cancer. N Engl J Med. 2019;380:711–9. https://doi.org/10.1056/nejmoa1814468 .
doi: 10.1056/nejmoa1814468
pubmed: 30511879
Khorana AA, Soff GA, Kakkar AK, Vadhan-Raj S, Riess H, Wun T, et al. Rivaroxaban for thromboprophylaxis in high-risk ambulatory patients with cancer. N Engl J Med. 2019;380:720–8. https://doi.org/10.1056/nejmoa1814630 .
doi: 10.1056/nejmoa1814630
pubmed: 30786186
Thachil J, Falanga A, Levi M, Liebman H, Di Nisio M. Management of cancer-associated disseminated intravascular coagulation: guidance from the SSC of the ISTH. J Thromb Haemost. 2015;13:671–5. https://doi.org/10.1111/jth.12838 .
doi: 10.1111/jth.12838
pubmed: 25556711
Wada H, Matsumoto T, Yamashita Y, Hatada T. Disseminated intravascular coagulation: testing and diagnosis. Clin Chim Acta. 2014;436:130–4. https://doi.org/10.1016/j.cca.2014.04.020 .
doi: 10.1016/j.cca.2014.04.020
pubmed: 24792730
Lee AYY, Levine MN, Baker RI, Bowden C, Kakkar AK, Prins M, et al. Low-Molecular-weight heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer. N Engl J Med. 2003;349:146–53. https://doi.org/10.1056/NEJMoa025313 .
doi: 10.1056/NEJMoa025313
pubmed: 12853587
Lillemoe KD, Cameron JL, Hardacre JM, Sohn TA, Sauter PK, Coleman J, et al. Is prophylactic gastrojejunostomy indicated for unresectable periampullary cancer? Ann Surg. 1999;230:322. https://doi.org/10.1097/00000658-199909000-00005 .
doi: 10.1097/00000658-199909000-00005
pubmed: 10493479
pmcid: 1420877
Adler DG, Baron TH. Endoscopic palliation of malignant gastric outlet obstruction using self-expanding metal stents: experience in 36 patients. Am J Gastroenterol. 2002;97:72–8. https://doi.org/10.1111/j.1572-0241.2002.05423.x .
doi: 10.1111/j.1572-0241.2002.05423.x
pubmed: 11808972
Jeurnink SM, Steyerberg EW, van Hooft JE, van Eijck CHJ, Schwartz MP, Vleggaar FP, et al. Surgical gastrojejunostomy or endoscopic stent placement for the palliation of malignant gastric outlet obstruction (SUSTENT study): a multicenter randomized trial. Gastrointest Endosc. 2010;71:490–9. https://doi.org/10.1016/j.gie.2009.09.042 .
doi: 10.1016/j.gie.2009.09.042
pubmed: 20003966
Ly J, O’Grady G, Mittal A, Plank L, Windsor JA. A systematic review of methods to palliate malignant gastric outlet obstruction. Surg Endosc. 2010;24:290–7. https://doi.org/10.1007/s00464-009-0577-1 .
doi: 10.1007/s00464-009-0577-1
pubmed: 19551436
Barkin JS, Goldberg RI, Sfakianakis GN, Levi J. Pancreatic carcinoma is associated with delayed gastric emptying. Dig Dis Sci. 1986;31:265–7. https://doi.org/10.1007/BF01318117 .
doi: 10.1007/BF01318117
pubmed: 3004847
Gurusamy KS, Kumar S, Davidson BR. Prophylactic gastrojejunostomy for unresectable periampullary carcinoma. Cochrane Database Syst Rev. 2013. https://doi.org/10.1002/14651858.CD008533.pub3 .
doi: 10.1002/14651858.CD008533.pub3
pubmed: 24346957
pmcid: 6464772
Nagaraja V, Eslick GD, Cox MR. Endoscopic stenting versus operative gastrojejunostomy for malignant gastric outlet obstruction-a systematic review and meta-analysis of randomized and non-randomized trials. J Gastrointest Oncol. 2014;5:92–8. https://doi.org/10.3978/j.issn.2078-6891.2014.016 .
doi: 10.3978/j.issn.2078-6891.2014.016
pubmed: 24772336
pmcid: 3999630
Yoshida Y, Fukutomi A, Tanaka M, Sugiura T, Kawata N, Kawai S, et al. Gastrojejunostomy versus duodenal stent placement for gastric outlet obstruction in patients with unresectable pancreatic cancer. Pancreatology. 2017;17:983–9. https://doi.org/10.1016/j.pan.2017.09.011 .
doi: 10.1016/j.pan.2017.09.011
pubmed: 29066391
Jeurnink SM, Steyerberg EW, Hof G van ’T, van Eijck CHJ, Kuipers EJ, Siersema PD. Gastrojejunostomy versus stent placement in patients with malignant gastric outlet obstruction: a comparison in 95 patients. J Surg Oncol 2007;96:389–96. https://doi.org/10.1002/jso.20828 .
Jeurnink SM, van Eijck CH, Steyerberg EW, Kuipers EJ, Siersema PD. Stent versus gastrojejunostomy for the palliation of gastric outlet obstruction: a systematic review. BMC Gastroenterol. 2007;7:18. https://doi.org/10.1186/1471-230X-7-18 .
doi: 10.1186/1471-230X-7-18
pubmed: 17559659
pmcid: 1904222
van Hooft JE, Dijkgraaf MGW, Timmer R, Siersema PD, Fockens P. Independent predictors of survival in patients with incurable malignant gastric outlet obstruction: a multicenter prospective observational study. Scand J Gastroenterol. 2010;45:1217–22. https://doi.org/10.3109/00365521.2010.487916 .
doi: 10.3109/00365521.2010.487916
pubmed: 20459356
Perez-Miranda M, Tyberg A, Poletto D, Toscano E, Gaidhane M, Desai AP, et al. EUS-guided gastrojejunostomy versus laparoscopic gastrojejunostomy. J Clin Gastroenterol. 2017;51:896–9. https://doi.org/10.1097/MCG.0000000000000887 .
doi: 10.1097/MCG.0000000000000887
pubmed: 28697151
Sturm A, Holtmann G, Goebell H, Gerken G. Prokinetics in patients with gastroparesis: a systematic analysis. Digestion. 1999;60:422–7. https://doi.org/10.1159/000007687 .
doi: 10.1159/000007687
pubmed: 10473966
Dormann A, Meisner S, Verin N, Wenk LA. Self-expanding metal stents for gastroduodenal malignancies: systematic review of their clinical effectiveness. Endoscopy. 2004;36:543–50. https://doi.org/10.1055/s-2004-814434 .
doi: 10.1055/s-2004-814434
pubmed: 15202052
Hidalgo M. Pancreatic Cancer. N Engl J Med. 2010;362:1605–17. https://doi.org/10.1056/NEJMra0901557 .
doi: 10.1056/NEJMra0901557
pubmed: 20427809
Distler M, Kersting S, Rückert F, et al. Palliative treatment of obstructive jaundice in patients with carcinoma of the pancreatic head or distal biliary tree. Endoscopic stent placement vs hepaticojejunostomy JOP. 2010;11:568–74.
pubmed: 21068488
Zorrón PuL, De Moura EGH, Bernardo WM, Baracat FI, Mendonça EQ, Kondo A, et al. Endoscopic stenting for inoperable malignant biliary obstruction: a systematic review and meta-analysis. World J Gastroenterol. 2015;21:13374. https://doi.org/10.3748/wjg.v21.i47.13374 .
doi: 10.3748/wjg.v21.i47.13374
Sawas T, Al Halabi S, Parsi MA, Vargo JJ. Self-expandable metal stents versus plastic stents for malignant biliary obstruction: a meta-analysis. Gastrointest Endosc. 2015;82:256-267.e7. https://doi.org/10.1016/j.gie.2015.03.1980 .
doi: 10.1016/j.gie.2015.03.1980
pubmed: 25982849
Dumonceau J-M, Tringali A, Papanikolaou I, Blero D, Mangiavillano B, Schmidt A, et al. Endoscopic biliary stenting: indications, choice of stents, and results: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline – Updated October 2017. Endoscopy. 2018;50:910–30. https://doi.org/10.1055/a-0659-9864 .
doi: 10.1055/a-0659-9864
pubmed: 30086596
Paik WH, Park YS, Hwang J-H, Lee SH, Yoon CJ, Kang S-G, et al. Palliative treatment with self-expandable metallic stents in patients with advanced type III or IV hilar cholangiocarcinoma: a percutaneous versus endoscopic approach. Gastrointest Endosc. 2009;69:55–62. https://doi.org/10.1016/j.gie.2008.04.005 .
doi: 10.1016/j.gie.2008.04.005
pubmed: 18657806
Wang AY, Strand DS, Shami VM. Prevention of post–endoscopic retrograde cholangiopancreatography pancreatitis: medications and techniques. Clin Gastroenterol Hepatol. 2016;14:1521-1532.e3. https://doi.org/10.1016/j.cgh.2016.05.026 .
doi: 10.1016/j.cgh.2016.05.026
pubmed: 27237430
Dietrich C, Lorentzen T, Appelbaum L, Buscarini E, Cantisani V, Correas J, et al. EFSUMB guidelines on interventional ultrasound (INVUS), part III – abdominal treatment procedures (short version). Ultraschall Der Medizin - Eur J Ultrasound. 2016;37:27–45. https://doi.org/10.1055/s-0035-1553965 .
doi: 10.1055/s-0035-1553965
Wang Y, Yuan C, Liu X. Characteristics of gastrointestinal hemorrhage associated with pancreatic cancer: a retrospective review of 246 cases. Mol Clin Oncol. 2015;3:902–8. https://doi.org/10.3892/mco.2015.563 .
doi: 10.3892/mco.2015.563
pubmed: 26171204
pmcid: 4486881
Yu P, Gong J. Hemosuccus pancreaticus: a mini-review. Ann Med Surg. 2018;28:45–8. https://doi.org/10.1016/j.amsu.2018.03.002 .
doi: 10.1016/j.amsu.2018.03.002
Obleagă C V, Vere CC, Mogoanţa SŞ, Firuţ C, Meșina C, Ciorbagiu MC, et al. Upper gastrointestinal bleeding - initial manifestation of pancreatic head carcinoma. Curr Heal Sci J 2017;43:236–40. https://doi.org/10.12865/CHSJ.43.03.09 .
Lee SM, Jeong SY, Shin JH, Choi HC, Na JB, Won JH, et al. Transcatheter arterial embolization for gastrointestinal bleeding related to pancreatic adenocarcinoma: clinical efficacy and predictors of clinical outcome. Eur J Radiol. 2020;123: 108787. https://doi.org/10.1016/j.ejrad.2019.108787 .
doi: 10.1016/j.ejrad.2019.108787
pubmed: 31877509
Lee JA, Lim DH, Park W, Ahn YC, Huh SJ. Radiation therapy for gastric cancer bleeding. Tumori. 2009;95:726–30.
Takada R, Ioka T, Sueyoshi H, Ishida N, Yamai T, Fukutake N, et al. Duodenal hemorrhage from pancreatic cancer infiltration controlled through combination therapy with gemcitabine and S-1. Case Rep Gastroenterol. 2014;8:221–6. https://doi.org/10.1159/000364819 .
doi: 10.1159/000364819
pubmed: 25076866
pmcid: 4105947
Kamal F, Khan MA, Lee-Smith W, Sharma S, Imam Z, Jowhar D, et al. Efficacy and safety of tranexamic acid in acute upper gastrointestinal bleeding: meta-analysis of randomised controlled trials. Scand J Gastroenterol 2020:1–8. https://doi.org/10.1080/00365521.2020.1839963 .
Vimalraj V, Kannan DG, Sukumar R, Rajendran S, Jeswanth S, Jyotibasu D, et al. Haemosuccus pancreaticus: diagnostic and therapeutic challenges. HPB. 2009;11:345–50. https://doi.org/10.1111/j.1477-2574.2009.00063.x .
doi: 10.1111/j.1477-2574.2009.00063.x
pubmed: 19718363
pmcid: 2727089
Bleau BL, Gostout CJ, Sherman KE, Shaw MJ, Harford WV, Keate RF, et al. Recurrent bleeding from peptic ulcer associated with adherent clot: a randomized study comparing endoscopic treatment with medical therapy. Gastrointest Endosc. 2002;56:1–6. https://doi.org/10.1067/mge.2002.125365 .
doi: 10.1067/mge.2002.125365
pubmed: 12085028
Limongelli P. Management of delayed postoperative hemorrhage after pancreaticoduodenectomy. Arch Surg. 2008;143:1001. https://doi.org/10.1001/archsurg.143.10.1001 .
doi: 10.1001/archsurg.143.10.1001
pubmed: 18936380
Søgaard KK, Farkas DK, Pedersen L, Sørensen HT. Splanchnic venous thrombosis is a marker of cancer and a prognostic factor for cancer survival. Blood. 2015;126:957–63. https://doi.org/10.1182/blood-2015-03-631119 .
doi: 10.1182/blood-2015-03-631119
pubmed: 26089394
Wu M, Schuster M, Tadros M. Update on management of portal vein thrombosis and the role of novel anticoagulants. J Clin Transl Hepatol 2019;7:1–11. https://doi.org/10.14218/jcth.2018.00057 .
Sarin SK, Philips CA, Kamath PS, Choudhury A, Maruyama H, Nery FG, et al. Toward a comprehensive new classification of portal vein thrombosis in patients with cirrhosis. Gastroenterology. 2016;151:574-577.e3. https://doi.org/10.1053/j.gastro.2016.08.033 .
doi: 10.1053/j.gastro.2016.08.033
pubmed: 27575821
Regnault H, Emambux S, Lecomte T, Doat S, Dhooge M, Besson M, et al. Clinical outcome of portal vein thrombosis in patients with digestive cancers: a large AGEO multicenter study. Dig Liver Dis. 2018;50:285–90. https://doi.org/10.1016/j.dld.2017.11.001 .
doi: 10.1016/j.dld.2017.11.001
pubmed: 29183764
Tait C, Baglin T, Watson H, Laffan M, Makris M, Perry D, et al. Guidelines on the investigation and management of venous thrombosis at unusual sites. Br J Haematol. 2012;159:28–38. https://doi.org/10.1111/j.1365-2141.2012.09249.x .
doi: 10.1111/j.1365-2141.2012.09249.x
pubmed: 22881455
Janczak DT, Mimier MK, McBane RD, Kamath PS, Simmons BS, Bott-Kitslaar DM, et al. Rivaroxaban and apixaban for initial treatment of acute venous thromboembolism of atypical location. Mayo Clin Proc. 2018;93:40–7. https://doi.org/10.1016/j.mayocp.2017.10.007 .
doi: 10.1016/j.mayocp.2017.10.007
pubmed: 29217335
Sheth RA, Sabir SH, Parmet P, Amin R, Kuban JD, Huang SY, et al. Portomesenteric venous stenting for palliation of ascites and variceal bleeding caused by prehepatic portal hypertension. Oncologist. 2018;23:712–8. https://doi.org/10.1634/theoncologist.2017-0337 .
doi: 10.1634/theoncologist.2017-0337
pubmed: 29284759
Hasegawa T, Yamakado K, Takaki H, Nakatsuka A, Uraki J, Yamanaka T, et al. Portal venous stent placement for malignant portal venous stenosis or occlusion: who benefits? Cardiovasc Intervent Radiol. 2015;38:1515–22. https://doi.org/10.1007/s00270-015-1123-2 .
doi: 10.1007/s00270-015-1123-2
pubmed: 25990622
Hicks AM, Chou J, Capanu M, Lowery MA, Yu KH, O’Reilly EM. Pancreas adenocarcinoma: ascites, clinical manifestations, and management implications. Clin Colorectal Cancer. 2016;15:360–8. https://doi.org/10.1016/j.clcc.2016.04.014 .
doi: 10.1016/j.clcc.2016.04.014
pubmed: 27262896
pmcid: 5099112
Cavazzoni E, Bugiantella W, Graziosi L, Franceschini MS, Donini A. Malignant ascites: pathophysiology and treatment. Int J Clin Oncol. 2013;18:1–9. https://doi.org/10.1007/s10147-012-0396-6 .
doi: 10.1007/s10147-012-0396-6
pubmed: 22460778
Aslam N, Marino CR. Malignant ascites: new concepts in pathophysiology, diagnosis, and management. Arch Intern Med. 2001;161:2733–7. https://doi.org/10.1001/archinte.161.22.2733 .
doi: 10.1001/archinte.161.22.2733
pubmed: 11732940
Zebrowski BK, Liu W, Ramirez K, Akagi Y, Mills GB, Ellis LM. Markedly elevated levels of vascular endothelial growth factor in malignant ascites. Ann Surg Oncol. 1999;6:373–8. https://doi.org/10.1007/s10434-999-0373-0 .
doi: 10.1007/s10434-999-0373-0
pubmed: 10379858
Becker G, Galandi D, Blum HE. Malignant ascites: systematic review and guideline for treatment. Eur J Cancer. 2006;42:589–97. https://doi.org/10.1016/j.ejca.2005.11.018 .
doi: 10.1016/j.ejca.2005.11.018
pubmed: 16434188
Pockros PJ, Esrason KT, Nguyen C, Duque J, Woods S. Mobilization of malignant ascites with diuretics is dependent on ascitic fluid characteristics. Gastroenterology. 1992;103:1302–6. https://doi.org/10.1016/0016-5085(92)91520-E .
doi: 10.1016/0016-5085(92)91520-E
pubmed: 1397889
Sangisetty SL. Malignant ascites: a review of prognostic factors, pathophysiology and therapeutic measures. World J Gastrointest Surg. 2012;4:87. https://doi.org/10.4240/wjgs.v4.i4.87 .
doi: 10.4240/wjgs.v4.i4.87
pubmed: 22590662
pmcid: 3351493
Narayanan G, Pezeshkmehr A, Venkat S, Guerrero G, Barbery K. Safety and efficacy of the PleurX catheter for the treatment of malignant ascites. J Palliat Med. 2014;17:906–12. https://doi.org/10.1089/jpm.2013.0427 .
doi: 10.1089/jpm.2013.0427
pubmed: 24885753
pmcid: 4118699
Ito T, Hanafusa N, Iwase S, Noiri E, Nangaku M, Nakagawa K, et al. Effects of cell-free and concentrated ascites reinfusion therapy (CART) on symptom relief of malignancy-related ascites. Int J Clin Oncol. 2015;20:623–8. https://doi.org/10.1007/s10147-014-0750-y .
doi: 10.1007/s10147-014-0750-y
pubmed: 25239690
Hanada R, Yokomichi N, Kato C, Miki K, Oyama S, Morita T, et al. Efficacy and safety of reinfusion of concentrated ascitic fluid for malignant ascites: a concept-proof study. Support Care Cancer. 2018;26:1489–97. https://doi.org/10.1007/s00520-017-3980-5 .
doi: 10.1007/s00520-017-3980-5
pubmed: 29168037
Colombo N, Mangili G, Mammoliti S, Kalling M, Tholander B, Sternas L, et al. A phase II study of aflibercept in patients with advanced epithelial ovarian cancer and symptomatic malignant ascites. Gynecol Oncol. 2012;125:42–7. https://doi.org/10.1016/j.ygyno.2011.11.021 .
doi: 10.1016/j.ygyno.2011.11.021
pubmed: 22112608
Heiss MM, Murawa P, Koralewski P, Kutarska E, Kolesnik OO, Ivanchenko VV, et al. The trifunctional antibody catumaxomab for the treatment of malignant ascites due to epithelial cancer: Results of a prospective randomized phase II/III trial. Int J Cancer. 2010;127:2209–21. https://doi.org/10.1002/ijc.25423 .
doi: 10.1002/ijc.25423
pubmed: 20473913
pmcid: 2958458
Quoc Lam B, Shrivastava SK, Shrivastava A, Shankar S, Srivastava RK. The Impact of obesity and diabetes mellitus on pancreatic cancer: molecular mechanisms and clinical perspectives. J Cell Mol Med. 2020;24:7706–16. https://doi.org/10.1111/jcmm.15413 .
doi: 10.1111/jcmm.15413
pubmed: 32458441
pmcid: 7348166
Markabawi D, Kondapi D, Tambe V, Seth R. When it is not just DKA; diabetic ketoacidosis as a first presentation of pancreatic adenocarcinoma. Am J Emerg Med. 2018;36:1720.e1-1720.e2. https://doi.org/10.1016/j.ajem.2018.05.070 .
doi: 10.1016/j.ajem.2018.05.070
Willcox PA, Immelman EJ, Barron JL, Klaff LJ, Harries-Jones EP, Hainsworth M, et al. Pancreatic somatostatinoma: presentation with recurrent episodes of severe hyperglycaemia and ketoacidosis. Q J Med. 1988;68:559–71.
pubmed: 2855274
Kamp K, Feelders RA, Van Adrichem RCS, De Rijke YB, Van Nederveen FH, Kwekkeboom DJ, et al. Parathyroid hormone-related peptide (PTHrP) secretion by gastroenteropancreatic neuroendocrine tumors (GEP-NETs): Clinical features, diagnosis, management, and follow-up. J Clin Endocrinol Metab. 2014;99:3060–9. https://doi.org/10.1210/jc.2014-1315 .
doi: 10.1210/jc.2014-1315
pubmed: 24905065
López-Tomassetti-Fernández EM, Favre-Rizzo J, Delgado-Plasencia L, Hernández-Hernández JR. Hypercalcemia associated with adenosquamous pancreatic carcinoma: a reason to initiate palliative treatment. Rev Española Enfermedades Dig. 2013;105:425–8. https://doi.org/10.4321/S1130-01082013000700009 .
doi: 10.4321/S1130-01082013000700009
Vakiti A, Mewawalla P. Malignancy-Related Hypercalcemia.StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; Jul 25 2021.
Mirrakhimov A. Hypercalcemia of malignancy: An update on pathogenesis and management. N Am J Med Sci. 2015;7:483. https://doi.org/10.4103/1947-2714.170600 .
doi: 10.4103/1947-2714.170600
pubmed: 26713296
pmcid: 4683803
Rosner MH, Dalkin AC. Electrolyte disorders associated with cancer. Adv Chronic Kidney Dis. 2014;21:7–17. https://doi.org/10.1053/j.ackd.2013.05.005 .
doi: 10.1053/j.ackd.2013.05.005
pubmed: 24359982
McCurdy MT, Shanholtz CB. Oncologic emergencies. Crit Care Med. 2012;40:2212–22. https://doi.org/10.1097/CCM.0b013e31824e1865 .
doi: 10.1097/CCM.0b013e31824e1865
pubmed: 22584756
Rades D, Huttenlocher S, Schild SE, Bartscht T. Metastatic spinal cord compression from pancreatic cancer. Anticancer Res. 2014;34:3727–30.
pubmed: 24982394
Sasaki T, Sato T, Nakai Y, Sasahira N, Isayama H, Koike K. Brain metastasis in pancreatic cancer. Medicine (Baltimore). 2019;98: e14227. https://doi.org/10.1097/MD.0000000000014227 .
doi: 10.1097/MD.0000000000014227