Clinical Endoscopy

Focused Review Series: Expanding Indication: Interventional Endoscopic Management for Pancreaticobiliary Diseases

Endoscopic Palliation for Biliary and Pancreatic Malignancies: Recent Advances: Zaheer Nabi, D. Nageshwar Reddy; Clin Endosc 2019;52(3):226-234. Published online January 22, 2019; DOI: https://doi.org/10.5946/ce.2019.003

Malignancies of the pancreatobiliary system are usually unresectable at the time of diagnosis. As a consequence, a majority of these cases are candidates for palliative care. With advances in chemotherapeutic agents and multidisciplinary care, the survival rate in pancreatobiliary malignancies has improved. Therefore, there is a need to provide an effective and long-lasting palliative care for these patients. Endoscopic palliation is preferred to surgery as the former is associated with equal efficacy and reduced morbidity. The main role of endoscopic palliation in the vast majority of pancreatobiliary malignancies includes biliary and enteral stenting for malignant obstructive jaundice and gastric outlet obstruction, respectively. Recent advances in endoscopic palliation appear promising in imparting long-lasting relief of symptoms. Use of radiofrequency ablation and photodynamic therapy in malignant biliary obstruction has been shown to improve the survival rates as well as the patency of biliary stents. The emergence of endoscopic ultrasound (EUS) as a therapeutic tool has enhanced the capability of minimally invasive palliation in pancreatobiliary cancers. EUS is a valuable alternative to endoscopic retrograde cholangiopancreatography for the palliation of obstructive jaundice. More recently, EUS is emerging as an effective primary modality for biliary and gastric bypass.

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David J Sanders, Shivanand Bomman, Rajesh Krishnamoorthi, Richard A Kozarek
World Journal of Gastrointestinal Endoscopy.2021; 13(8): 260. CrossRef
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Endosonography-guided Radiofrequency Ablation in Pancreatic Diseases
Giuseppe Vanella, Gabriele Capurso, Paolo G. Arcidiacono
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Efficacy and safety of radiofrequency ablation in patients with unresectable malignant biliary strictures
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Focused Review Series: Updates on Gastrointestinal and Pancreaticobiliary Stents

Update on Pancreatobiliary Stents: Stent Placement in Advanced Hilar Tumors: Sung Ill Jang, Dong Ki Lee; Clin Endosc 2015;48(3):201-208. Published online May 29, 2015; DOI: https://doi.org/10.5946/ce.2015.48.3.201

Abstract PDF PubReader ePub

Palliative drainage is the main treatment option for inoperable hilar cholangiocarcinoma to improve symptoms, which include cholangitis, pruritus, high-grade jaundice, and abdominal pain. Although there is no consensus on the optimal method for biliary drainage due to the paucity of large-scale randomized control studies, several important aspects of any optimal method have been studied. In this review article, we discuss the liver volume to be drained, stent type, techniques to insert self-expanding metal stents, and approaches for proper and effective biliary drainage based on previous studies and personal experience.

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Clinical Endoscopy.2016; 49(2): 124. CrossRef

9,430 View
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