Yousaf Muhammad Nadeem, Ehsan Hamid, Wahab Ahsan, Muneeb Ahmad, Chaudhary Fizah S, Williams Richard, Haas Christopher J
Department of Medicine, Medstar Union Memorial Hospital, Baltimore, MD 21218, United States.
Department of Hospital Medicine, Baptist Medical Center South, Montgomery, AL 36116, United States.
World J Gastrointest Endosc. 2020 Oct 16;12(10):323-340. doi: 10.4253/wjge.v12.i10.323.
Pancreatic cancer is the leading cause of cancer-related morbidity and mortality with an overall five-year survival of less than 9% in the United States. At presentation, the majority of patients have painless jaundice, pruritis, and malaise, a triad that develops secondary to obstruction, which often occurs late in the course of the disease process. The technical advancements in radiological imaging and endoscopic interventions have played a crucial role in the diagnosis, staging, and management of patients with pancreatic cancer. Endoscopic retrograde cholangiopancreatography (ERCP)-guided diagnosis (with brush cytology, serial pancreatic juice aspiration cytologic examination technique, or biliary biopsy) and therapeutic interventions such as pancreatobiliary decompression, intraductal and relief of gastric outlet obstruction play a pivotal role in the management of advanced pancreatic cancer and are increasingly used due to improved morbidity and complication rates compared to surgical management. In this review, we highlight various ERCP-guided diagnostic and therapeutic interventions for the management of pancreatic cancer.
胰腺癌是癌症相关发病和死亡的主要原因，在美国总体五年生存率低于9%。就诊时，大多数患者有无痛性黄疸、瘙痒和不适，这一组症状继发于梗阻，而梗阻常在疾病进程后期出现。放射影像学和内镜干预的技术进步在胰腺癌患者的诊断、分期和管理中发挥了关键作用。内镜逆行胰胆管造影（ERCP）引导下的诊断（通过刷检细胞学、连续胰液抽吸细胞学检查技术或胆管活检）以及诸如胰胆管减压、导管内治疗和解除胃出口梗阻等治疗干预措施在晚期胰腺癌的管理中起着关键作用，并且由于与手术管理相比发病率和并发症发生率有所改善，其使用越来越广泛。在本综述中，我们重点介绍各种用于胰腺癌管理的ERCP引导下的诊断和治疗干预措施。
