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Coordination of Endoscopic Ultrasound-Guided FNA and Biliary Drainage in Pancreatic Cancer

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Management of Localized Pancreatic Cancer

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Abstract

Over a period of three decades from 1980 to 2000, pancreatic cancer (PC)-related mortality rates have virtually remained unchanged [1]. In an attempt to improve survival outcomes, some of the approaches introduced in the recent past have included giving neoadjuvant therapy even to patients with resectable PCs and using molecular profiling of the cancer to deliver tailored chemotherapy. The rationale behind using neoadjuvant therapy followed by pancreaticoduodenectomy (“delayed surgery”) is discussed in other chapters in this book. As compared to “early surgery” (pancreaticoduodenectomy followed by adjuvant therapy), the approach of using neoadjuvant therapy has had a significant impact on the role and timing of endoscopy in patients with PC, especially with regard to procedures like endoscopic ultrasound (EUS), fine needle aspiration (FNA) or aspiration biopsy (FNAB), and endoscopic retrograde cholangiopancreatography (ERCP). The focus of this chapter will be on the coordination of EUS-FNA/FNAB and ERCP in patients in whom surgery is going to be delayed.

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Abbreviations

ERCP::

Endoscopic Retrograde Cholangiopancreatography

EUS::

Endoscopic Ultrasound

FNA::

Fine Needle Aspiration

FNAB::

Fine Needle Aspiration Biopsy

PC::

Pancreatic cancer

ROSE::

Rapid On-Site Evaluation

SEMS::

Self-expanding Metal Stent (Biliary)

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Authors and Affiliations

  1. Department of Medicine, Division of Gastroenterology and Hepatology, The Medical College of Wisconsin, Milwaukee, WI, USA

    Kulwinder S. Dua

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  1. Kulwinder S. Dua
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Correspondence to Kulwinder S. Dua .

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Editors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, The Medical College of Wisconsin, Milwaukee, WI, USA

    Susan Tsai

  2. Division of Medical Oncology, Department of Medicine, The Medical College of Wisconsin, Milwaukee, WI, USA

    Paul S. Ritch

  3. Department of Radiation Oncology, The Medical College of Wisconsin, Milwaukee, WI, USA

    Beth A. Erickson

  4. Department of Surgery, The Medical College of Wisconsin, Milwaukee, WI, USA

    Douglas B. Evans

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Dua, K.S. (2019). Coordination of Endoscopic Ultrasound-Guided FNA and Biliary Drainage in Pancreatic Cancer. In: Tsai, S., Ritch, P., Erickson, B., Evans, D. (eds) Management of Localized Pancreatic Cancer . Springer, Cham. https://doi.org/10.1007/978-3-319-98944-0_3

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  • DOI: https://doi.org/10.1007/978-3-319-98944-0_3

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  • Online ISBN: 978-3-319-98944-0

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