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World J Gastroenterol. Jan 21, 2022; 28(3): 332-347
Published online Jan 21, 2022. doi: 10.3748/wjg.v28.i3.332
Endoscopic ultrasound role in pancreatic adenocarcinoma treatment: A review focusing on technical success, safety and efficacy
Wisam Sbeit, Bertrand Napoléon, Tawfik Khoury
Wisam Sbeit, Tawfik Khoury, Department of Gastroenterology, Galilee Medical Center, Faculty of Medicine in the Galilee, Bar-Ilan University, Nahariya 2221006, Israel
Bertrand Napoléon, Department of Endoscopy Unit, Private Hospital Jean Mermoz, Ramsay Generale de Sante, Lyon 69008, France
Author contributions: Khoury T and Sbeit W contributed to study design and concept; Napoléon B contributed to critical revision of the manuscript; all authors contributed to data analysis, writing the initial draft and approved the final version to be published.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tawfik Khoury, MD, Doctor, Lecturer, Senior Researcher, Department of Gastroenterology, Galilee Medical Center, Faculty of Medicine in the Galilee, Bar-Ilan University, Meona Street, Nahariya 2221006, Israel. tawfik.khoury.83@gmail.com
Received: September 28, 2021
Peer-review started: September 28, 2021
First decision: November 18, 2021
Revised: November 22, 2021
Accepted: January 6, 2022
Article in press: January 6, 2022
Published online: January 21, 2022
Processing time: 107 Days and 1.1 Hours
Abstract

The impressive technological advances in recent years have rapidly translated into the shift of endoscopic ultrasound (EUS) from diagnostic modality into an interventional and therapeutic tool. Despite the great advance in its diagnosis, the majority of pancreatic adenocarcinoma cases are inoperable when diagnosed, thus demanding alternative optional therapies. EUS has emerged as an easy, minimally invasive modality targeting this carcinoma with different interventions that have been reported recently. In this review we summarize the evolving role of interventional therapeutic EUS in pancreatic adenocarcinoma management.

Keywords: Endoscopic ultrasound; Pancreas; Cancer; Management; Palliative

Core Tip: The prognosis of pancreatic adenocarcinoma is poor in advanced stages. Several studies were conducted recently to assess the effect of different treatment options provided through endoscopic ultrasound (EUS). We present a comprehensive review on the role of EUS in unresectable pancreatic adenocarcinoma treatment while exploring its effect on survival and palliation. We found that EUS-guided intervention is feasible with excellent technical success, limited adverse events, a beneficial effect on cancer-associated pain and an as-yet unknown effect on survival. For EUS-assisted therapies there are still many unknowns and unanswered questions, prompting the need for additional prospective randomized controlled studies comparing the different treatment approaches combined with chemo +/- radiotherapy with respect to success, efficacy, safety and survival.