Endoscopic Palliation for Biliary and Pancreatic Malignancies: Recent Advances

다국어 초록 (Multilingual Abstract)

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

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