What are the current and potential future roles for endoscopic ultrasound in the treatment of pancreatic cancer?

• 作者: Richard A Kozarek Shayan Irani Stephen Y Oh
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: ENDOSCOPIC ultrasound Pancreatic cancer PALLIATION ENDOSCOPIC ULTRASOUND-GUIDED CELIAC PLEXUS NEUROLYSIS and block ENDOSCOPIC ULTRASOUND-GUIDED biliary drainage ENDOSCOPIC ULTRASOUND-GUIDED gastrojejunal anastomosis ENDOSCOPIC ULTRASOUND-GUIDED antitumor therapy
• 年，卷（期）: 2016,（7）
• 页码范围: 319-329
• 页数: 11页
• 分类号: R

摘要

Pancreatic adenocarcinoma is the fourth leading cause of cancer-related death in the United States. Due to the aggressive tumor biology and late manifestations of the disease, long-term survival is extremely uncommon and the current 5-year survival rate is 7%.Over the last two decades, endoscopic ultrasound (EUS) has evolved from a diagnostic modality to a minimally invasive therapeutic alternative to radiologic procedures and surgery for pancreatic diseases. EUSguided celiac plexus intervention is a useful adjunct to conventional analgesia for patients with pancreatic cancer. EUS-guided biliary drainage has emerged as a viable option in patients who have failed endoscopic retrograde cholangiopancreatography. Recently, the use of lumen-apposing metal stent to create gastrojejunal anastomosis under EUS and fluoroscopic guidance in patients with malignant gastric outlet obstruction has been reported. On the other hand, anti-tumor therapies delivered by EUS, such as the injection of anti-tumor agents, brachytherapy and ablations are still in the experimental stage without clear survival benefit. In this article, we provide updates on well-established EUS-guided interventions as well as novel techniques relevant to pancreatic cancer.