Endoscopic Methods in the Diagnosis and Treatment of Pancreatic Cancer

摘要

Endoscopic methods are widely used in the diagnosis and palliative treatment of pancreatic cancer. The most sensitive method in early diagnosis is endosonography (EUS) which can also provide histological diagnosis. Diagnostic ERCP became a rather rare procedure as a consequence of wide availability of Magnetic Resonance Cholangiopancreatography (MRCP) but ERCP assisted intraductal methods have gained importance (brush-cytology, intraductal ultrasound, optical coherence tomography) and finally, peroral pancreatoscopy has become technically feasible but available only in some specialized centers. Minimally invasive endoscopic methods play an important role in the palliative treatment of unresectable pancreatic cancer which represents the majority of cases. EUS-guided histological confirmation of adenocarcinoma is crucial in the election of chemotherapy. Celiac plexus blockade and endoscopic biliary and pancreatic stent placement contribute to pain reduction, drainage of obstructed bile duct and assure a better quality of life.