Palliative Endoscopic Therapy in Pancreatic Cancer

Endoscopic palliation in pancreatic cancer patients is an evolving topic due to the rising incidence and longer survival rates of patients diagnosed in a metastasized stadium. The expansive growth of malignant tumors of the pancreas causes secondary problems that often can be addressed via endoscopic procedures. The diagnostic value of ERCP imaging has been decreasing quickly, while interventional possibilities and procedures are evolving quickly. With increasing interventional possibilities, the right choice of intervention method, timing and sequence become more important to ensure maximal benefit with the least amount of interventional sessions and costs. In this article, palliative endoscopic interventions are discussed addressing biliary, pancreatic and luminal obstruction as well as EUS guided placement of therapeutic agents and their sequence and timing.