Endoscopic ultrasound guided interventions in the management of pancreatic cancer

Core Tip

Core Tip: Interventional endoscopic ultrasound in pancreatic cancer has been developed via a through-the-needle fashion, using 2 techniques: Injection and/or placement. Examples of through-the-needle injection techniques include intratumoral therapy, injection of alcohol and bupivacaine for celiac plexus neurolysis, and hydrogel for bleb formation to create space in the pancreaticoduodenal groove for dose-escalation stereotactic body radiation therapy. Examples of through-the-needle placement techniques include placement of fiducial markers, placement of ablative probes for non-thermal and thermal therapies, placement of radioactive seeds for brachytherapy, and placement of a lumen-apposing metal stent to create a gastrojejunostomy in patients with gastric outlet obstruction. The vast majority of these techniques have shown comparable or superior outcomes when compared to conventional interventions and therapies.