Palliative measures in hepatobiliopancreat system

Malignant tumors of the hepatobiliopancreatic system are not curable in > 6 0 %. For this reason, palliation plays an important therapeutic role. Indic ations are mainly obstructive jaundice, duodenal obstruction and pain. Asse ssment of the tumor's morphology and resectability is often possible only b y surgical exploration. If necessary and feasible, non-curable malignancies are treated synchronously during this operation. In preoperatively proven distant metastases or local nonresectability, interventional procedures are preferred. They are efficient, at least primarily, and mostly correlated w ith little patient discomfort. A surgical biliary bypass obviously leads to improved long-term palliation. Especially in Klatskin tumors, palliative r esection may be useful. Generally the patients benefit from palliation depe nds on minor therapeutic discomfort and long-lasting control of symptoms.