Endoscopic Palliation of Pancreatic Cancer: Biliary and Duodenal Stenting

  • Giuseppe Feliciangeli
  • Giampiero Macarri
  • Silvia Taffetani
  • Antonio Benedetti
Part of the Updates in Surgery book series (UPDATESSURG)


Ductal pancreatic adenocarcinoma is the second most common malignant neoplasm of the gastrointestinal tract and the fifth most common cause of neoplasia- related death in USA [1, 2]. Although progress in diagnosis and in medical and surgical treatment has been made, the median survival is less than 6 months and the survival rate at 5 years is 3–5‰. At diagnosis most patients already have locally advanced disease with vascular invasion and/or metastatic lesions, which rule out a curative surgical approach. In the minority of patients in whom radical surgery is possible, survival at 5 years is still 15–20‰. For these reasons, palliation is the cornerstone of treatment for most patients with pancreatic adenocarcinoma.


Pancreatic Cancer Biliary Stricture Metallic Stents Gastric Outlet Obstruction Plastic Stents 
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  1. 1.
    Sanders M, Papachristou GI, McGrath KM, Slivka A (2007) Endoscopic palliation of pancreatic cancer. Gastroenterol Clin N Am 36:455–476CrossRefGoogle Scholar
  2. 2.
    Michaud DS (2002) The epidemiology of pancreatic, gallbladder, and other biliary tract cancers. Gastrointest Endosc 56:S195–S200CrossRefPubMedGoogle Scholar
  3. 3.
    Hawes RH (2002) Diagnostic and therapeutic uses of ERCP in pancreatic and biliary tract malignancies. Gastrointest Endosc 56:S201–S205CrossRefPubMedGoogle Scholar
  4. 4.
    Baron TH, Mallery JS, Hirota WK et al (2003) The role of endoscopy in the evaluation and treatment of patients with pancreaticobiliary malignancy. Gastrointest Endosc 58:643–649CrossRefPubMedGoogle Scholar
  5. 5.
    Shah JN, Muthusamy R (2005) Endoscopic palliation of pancreaticobiliary Malignancies. Gastrointest Endoscopy Clin N Am 15: 513–531CrossRefGoogle Scholar
  6. 6.
    Raijman I (2003) Biliary and pancreatic stents. Gastrointest Endosc Clin N Am 13:563–592CrossRefGoogle Scholar
  7. 7.
    Holt AP, Patel M, Ahmed MM (2004) Palliation of patients with malignant gastroduodenal obstruction with self-expanding metallic stents: the treatment of choice? Gastrointest Endosc 60:1010–1017CrossRefPubMedGoogle Scholar
  8. 8.
    Simmons DT, Baron TH (2005) Technology Insight: enteral stenting and ney technology. Nat Clin Pract Gastroenterol Hepatol 2:365–374CrossRefPubMedGoogle Scholar
  9. 9.
    Mutignani M, Tringali M, Shah SG et al (2007) Combined endoscopic stent insertion in malignant biliary and duodenal obstruction. Endoscopy 39:440–447CrossRefPubMedGoogle Scholar
  10. 10.
    Van Hooft J, Mutignani M, Repici A et al (2007) First data on the palliative treatment of patients with malignant gastric outlet obstruction using the WallFlex enteral stent: a retrospective multicenter study. Endoscopy 39:434–439CrossRefPubMedGoogle Scholar
  11. 11.
    Dormann A, Meisner S, Verin N et al (2004) Self-expanding metal stents for gastroduodenal malignancies: systematic review of their clinical effectiveness. Endoscopy 36:543–550CrossRefPubMedGoogle Scholar
  12. 12.
    Graber I, Dumas R, Filoche B et al (2007) The efficacy and safety of duodenal stenting: a prospective multicenter study. Endoscopy 39:784–787CrossRefPubMedGoogle Scholar
  13. 13.
    Tierney W, Chuttani R, Croffie J et al (2006) Technology Status Evaluation Report: Enteral stents. Gastrointest Endosc 63:920–926CrossRefPubMedGoogle Scholar
  14. 14.
    Baron TH, Harewood GC (2003) Enteral self-expandable stents. Gastrointest Endosc 58:421–433CrossRefPubMedGoogle Scholar
  15. 15.
    Del Piano M, Ballarè M, Montino F et al (2005) Endoscopy or surgery for malignant GI outlet obstruction? Gastrointest Endosc 61:421–426CrossRefPubMedGoogle Scholar
  16. 16.
    Seitz U, Block A, Schaefer AC et al (2007) Biliary stent clogging solved by nanotechnology? In vitro study of inorganic-organic sol-gel coatings for teflon stents. Gastroenterology 133:65–71CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2009

Authors and Affiliations

  • Giuseppe Feliciangeli
    • 1
  • Giampiero Macarri
    • 1
  • Silvia Taffetani
    • 1
  • Antonio Benedetti
    • 1
  1. 1.Department of Gastroenterology, Ospedali Riuniti University HospitalPolytechnic University of MarcheAnconaItaly

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