Endoscopic Palliation of Pancreatic Cancer

摘要: Pancreas cancer is a fourth-leading cause of death in the USA and its incidence rising as population aging. The majority patients present at an advanced stage due to silent nature disease treatment have focused more on palliation than curative intent. Gastroenterologists become integral multidisciplinary care these with focus providing endoscopic pancreas cancer. three most common areas that gastroenterologists palliate endoscopically are biliary obstruction, cancer-related pain, gastric outlet obstruction. To procedure choice perform retrograde cholangiopancreatography (ERCP) stent placement. We tend place covered self-expandable metal stents (SEMS) their longer patency removability unless patient has resectable disease. pain result tumor infiltration celiac plexus can be severe poorly responsive narcotics. improve control, neurolysis been performed for decades. Since 1996, area by Endoscopic Ultrasound-Guided Celiac Plexus Neurolysis. This proven safe effective traditional non-endoscopic methods allowed decrease narcotic use control. should done early course maximal effect. Gastric obstruction (GOO) occurs approximately 15–20% GOO placing uncovered enteral across very who short life expectancy (less two 6 months) while surgical bypass considered expectancies because it offers better long-term symptom relief. chapter will review current literature, latest advancements, optimal techniques pancreatic