Makar Michael, Zhao Eric, Tyberg Amy
Department of Internal Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA.
Division of Gastroenterology & Hepatology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA.
J Pers Med. 2021 Mar 4;11(3):180. doi: 10.3390/jpm11030180.
Pancreaticobiliary malignancies arise from different areas within the pancreas and biliary tree. Endoscopic ultrasound (EUS) is a well-recognized diagnostic and therapeutic modality in the treatment of pancreaticobiliary diseases, and more specifically, pancreaticobiliary malignancies. Traditionally used for diagnostic purposes, EUS plays a critical role in tissue sampling and cancer staging. The emergence of the new field of interventional EUS has allowed EUS to also play a critical role in therapeutic management. Novel interventional EUS procedures such as EUS-guided gastrojejunostomy (EUS-GE), EUS-guided biliary drainage (EUS-BD), and EUS-guided gallbladder drainage (EUS-GLB) can be utilized to treat complications of pancreaticobiliary malignancies such as gastric outlet obstruction, obstructive jaundice, and cholecystitis. In addition, interventional EUS procedures can be utilized for the palliation of unresectable malignancies both for source control with EUS-radiofrequency ablation (EUS-RFA) and for the treatment of abdominal pain refractory to opioid medications with EUS-guided celiac axis neurolysis. However, patient selection remains a critical component in both diagnostic and therapeutic interventions and must be tailored to individual patient wishes, disease pathology, and overall prognosis.
胰胆恶性肿瘤起源于胰腺和胆管树的不同部位。内镜超声（EUS）是治疗胰胆疾病，尤其是胰胆恶性肿瘤时一种公认的诊断和治疗方式。EUS传统上用于诊断目的，在组织采样和癌症分期中起着关键作用。介入性EUS这一新领域的出现使EUS在治疗管理中也发挥着关键作用。新型介入性EUS程序，如EUS引导下胃空肠吻合术（EUS-GE）、EUS引导下胆管引流术（EUS-BD）和EUS引导下胆囊引流术（EUS-GLB），可用于治疗胰胆恶性肿瘤的并发症，如胃出口梗阻、梗阻性黄疸和胆囊炎。此外，介入性EUS程序可用于不可切除恶性肿瘤的姑息治疗，既可以通过EUS射频消融术（EUS-RFA）进行源头控制，也可以通过EUS引导下腹腔神经丛松解术治疗对阿片类药物难治的腹痛。然而，患者选择仍然是诊断和治疗干预中的关键组成部分，必须根据患者的个人意愿、疾病病理和总体预后进行调整。
