Abstract
Endoscopic retrograde cholangiopancreatography (ERCP) is a safe and reliable method for the diagnosis, treatment, and palliation of pancreaticobiliary malignancy. In 2015, the estimated new cases of pancreatic cancer were about 48,960. The 5-year survival of pancreatic cancer is dismal at approximately 5% Siegel et al. (CA: Cancer J Clin 65(1):5–29, 2015). ERCP provides less invasive approaches to diagnosis with examination of the biliary and pancreatic ducts. The procedure also allows for therapeutic relief of biliary obstruction. Advanced endoscopic techniques offer palliation of symptoms related to advanced pancreatic cancer and improvement in quality of life. This chapter addresses the use of therapeutic endoscopy in the diagnosis and management of pancreatic adenocarcinoma.
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References
Eloubeidi MA, et al. The role of endoscopy in the evaluation and management of patients with solid pancreatic neoplasia. Gastrointest Endosc. 2016;83(1):17–28.
Kalady MF, et al. Pancreatic duct strictures: identifying risk of malignancy. Ann Surg Oncol. 2004;11(6):581–8.
Hartmann D, et al. ERCP and MRCP in the differentiation of pancreatic tumors. Dig Dis. 2004;22(1):18–25.
Andersson R, Vagianos CE, Williamson RCN. Preoperative staging and evaluation of resectability in pancreatic ductal adenocarcinoma. HPB. 2004;6(1):5–12.
Shah SA, Movson J, Ransil BJ, Waxman I. Pancreatic duct stricture length at ERCP predicts tumor size and pathological stage of pancreatic cancer. Am J Gastroenterol. 1997;92(6):964–7.
Asbun HJ, et al. When to perform a pancreatoduodenectomy in the absence of positive histology? A consensus statement by the International Study Group of Pancreatic Surgery. Surgery. 2014;155(5):887–92.
Kim YS, et al. The significance of p53 and K-ras immunocytochemical staining in the diagnosis of malignant biliary obstruction by Brush Cytology during ERCP. Gut Liver. 2010;4(2):219–25.
Wight CO, et al. Improving diagnostic yield of biliary brushings cytology for pancreatic cancer and cholangiocarcinoma. Cytopathology. 2004;15(2):87–92.
Kipp BR, et al. A comparison of routine cytology and fluorescence in situ hybridization for the detection of malignant bile duct strictures. Am J Gastroenterol. 2004;99(9):1675–81.
Gonda TA, et al. Polysomy and p16 deletion by fluorescence in situ hybridization in the diagnosis of indeterminate biliary strictures. Gastrointest Endosc. 2012;75(1):74–9.
Naitoh I, et al. Predictive factors for positive diagnosis of malignant biliary strictures by transpapillary brush cytology and forceps biopsy. J Dig Dis. 2016;17(1):44–51.
Navaneethan U, et al. Comparative effectiveness of biliary brush cytology and intraductal biopsy for detection of malignant biliary strictures: a systematic review and meta-analysis. Gastrointest Endosc. 2015;81(1):168–76.
Yang J, et al. K-ras mutational status in cytohistological tissue as a molecular marker for the diagnosis of pancreatic cancer: a systematic review and meta-analysis. Dis Markers. 2014;2014:573783.
Mikata R, et al. Clinical usefulness of repeated pancreatic juice cytology via endoscopic naso-pancreatic drainage tube in patients with pancreatic cancer. J Gastroenterol. 2013;48(7):866–73.
Tada M, et al. Analysis of K-ras gene mutation in hyperplastic duct cells of the pancreas without pancreatic disease. Gastroenterology. 1996;110(1):227–31.
Gress TM. Molecular diagnosis of pancreatobiliary malignancies in brush cytologies of biliary strictures. Gut. 2004;53(12):1727–9.
Fukuda Y, et al. Diagnostic utility of peroral cholangioscopy for various bile-duct lesions. Gastrointest Endosc. 2005;62(3):374–82.
Chen YK, et al. Single-operator cholangioscopy in patients requiring evaluation of bile duct disease or therapy of biliary stones (with videos). Gastrointest Endosc. 2011;74(4):805–14.
Parsi MA, et al. Diagnostic and therapeutic cholangiopancreatoscopy: performance of a new digital cholangioscope. Gastrointest Endosc. 2014;79(6):936–42.
Kurihara T, et al. Diagnostic and therapeutic single-operator cholangiopancreatoscopy in biliopancreatic diseases: prospective multicenter study in Japan. World J Gastroenterol. 2016;22(5):1891–901.
Smith AC, et al. Randomised trial of endoscopic steriting versus surgical bypass in malignant low bile duct obstruction. Lancet. 1994;344(8938):1655–60.
Abraham NS, Barkun JS, Barkun AN. Palliation of malignant biliary obstruction: a prospective trial examining impact on quality of life. Gastrointest Endosc. 2002;56(6):835–41.
Ballinger AB, et al. Symptom relief and quality of life after stenting for malignant bile duct obstruction. Gut. 1994;35(4):467–70.
Pfau PR, et al. Pancreatic and biliary stents. Gastrointest Endosc. 2013;77(3):319–27.
Boulay BR, Parepally M. Managing malignant biliary obstruction in pancreas cancer: choosing the appropriate strategy. World J Gastroenterol. 2014;20(28):9345–53.
Kullman E, et al. Covered versus uncovered self-expandable nitinol stents in the palliative treatment of malignant distal biliary obstruction: results from a randomized, multicenter study. Gastrointest Endosc. 2010;72(5):915–23.
Isayama H, et al. Cholecystitis after metallic stent placement in patients with malignant distal biliary obstruction. Clin Gastroenterol Hepatol. 2006;4(9):1148–53.
Maire F, et al. Long-term outcome of biliary and duodenal stents in palliative treatment of patients with unresectable adenocarcinoma of the head of pancreas. Am J Gastroenterol. 2006;101(4):735–42.
Soderlund C, Linder S. Covered metal versus plastic stents for malignant common bile duct stenosis: a prospective, randomized, controlled trial. Gastrointest Endosc. 2006;63(7):986–95.
Cavell LK, et al. Biliary self-expandable metal stents do not adversely affect pancreaticoduodenectomy. Am J Gastroenterol. 2013;108(7):1168–73.
Sasahira N, et al. Multicenter study of endoscopic preoperative biliary drainage for malignant distal biliary obstruction. World J Gastroenterol. 2016;22(14):3793–802.
Fang Y, et al. Pre-operative biliary drainage for obstructive jaundice. Cochrane Database Syst Rev. 2012;9:CD005444.
Gavazzi F, et al. Role of preoperative biliary stents, bile contamination and antibiotic prophylaxis in surgical site infections after pancreaticoduodenectomy. BMC Gastroenterol. 2016;16:43.
Aadam AA, et al. Efficacy and safety of self-expandable metal stents for biliary decompression in patients receiving neoadjuvant therapy for pancreatic cancer: a prospective study. Gastrointest Endosc. 2012;76(1):67–75.
Fathi A, et al. Neoadjuvant therapy for localized pancreatic cancer: guiding principles. J Gastrointest Oncol. 2015;6(4):418–29.
Sanders MK, et al. EUS-guided fiducial placement for stereotactic body radiotherapy in locally advanced and recurrent pancreatic cancer. Gastrointest Endosc. 2010;71(7):1178–84.
Chavalitdhamrong D, et al. Technical advances in endoscopic ultrasound-guided fiducial placement for the treatment of pancreatic cancer. Endosc Int Open. 2015;3(4):E373–7.
Stark A, Hines OJ. Endoscopic and operative palliation strategies for pancreatic ductal adenocarcinoma. Semin Oncol. 2015;42(1):163–76.
Maetani I. Self-expandable metallic stent placement for palliation in gastric outlet obstruction. Ann Palliat Med. 2014;3(2):54–64.
Sasaki R, et al. Endoscopic management of unresectable malignant gastroduodenal obstruction with a nitinol uncovered metal stent: a prospective Japanese multicenter study. World J Gastroenterol. 2016;22(14):3837–44.
Mehta S, et al. Prospective randomized trial of laparoscopic gastrojejunostomy versus duodenal stenting for malignant gastric outflow obstruction. Surg Endosc Int Tech. 2006;20(2):239–42.
Puli SR, et al. EUS-guided celiac plexus neurolysis for pain due to chronic pancreatitis or pancreatic cancer pain: a meta-analysis and systematic review. Dig Dis Sci. 2009;54(11):2330–7.
Alvarez-Sánchez MV, et al. Interventional endoscopic ultrasonography: an overview of safety and complications. Surg Endosc. 2014;28(3):712–34.
Costamagna G, et al. Treatment of “obstructive” pain by endoscopic drainage in patients with pancreatic head carcinoma. Gastrointest Endosc. 1993;39(6):774–7.
Wehrmann T, et al. Endoscopic pancreatic duct stenting for relief of pancreatic cancer pain. Eur J Gastroenterol Hepatol. 2005;17(12):1395–400.
Sanders M, et al. Endoscopic palliation of pancreatic cancer. Gastroenterol Clin North Am. 2007;36(2):455–76.
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McGhan, A., Burbridge, R. (2018). Therapeutic Endoscopy in the Management of Pancreatic Cancer. In: Neoptolemos, J., Urrutia, R., Abbruzzese, J., Büchler, M. (eds) Pancreatic Cancer. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-7193-0_87
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DOI: https://doi.org/10.1007/978-1-4939-7193-0_87
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