Endoscopy in the Evaluation and Management of Patients with Solid Pancreatic Neoplasia
Publication Date: January 3, 2016
Last Updated: March 14, 2022
Recommendations
We recommend that imaging evaluation of patients with suspected solid pancreatic neoplasia include EUS and multidetector pancreas protocol CT scans with selective use of MRI and PET-CT when appropriate. (⊕⊕⊕⊕)
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We recommend that EUS be performed for evaluation of pancreatic masses and suspected malignancy, particularly when CT detection or evaluation of resectability is equivocal. (⊕⊕⊕⊕)
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We recommend that biopsy of a suspected primary or metastatic pancreatic tumor should be individualized based on need for preoperative chemotherapy, resectability, and feasibility of surgery. (⊕⊕⊕⊕)
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We suggest that EUS-guided celiac plexus neurolysis be considered in patients with pancreatic cancer–related pain. (⊕⊕⊕o)
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We do not recommend preoperative ERCP in patients with obstructive jaundice because of resectable adenocarcinoma of the pancreas in the absence of cholangitis unless a substantial delay in operative resection of a symptomatic patient is anticipated. (⊕⊕⊕o)
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We recommend that patients with symptomatic, unresectable adenocarcinoma of the pancreas with biliary and/or gastroduodenal obstruction undergo attempted palliation with endoscopic stent placement as the preferred therapeutic modality. (⊕⊕⊕o)
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We recommend EUS ± FNA for localization and characterization of suspected pancreatic neuroendocrine tumors and metastatic solid pancreatic neoplasia. (⊕⊕⊕o)
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We suggest EUS-guided fiducial placement into a pancreatic malignancy if image-guided radiation therapy is considered. (⊕⊕⊕o)
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We suggest that screening with EUS and MRCP should be offered to high-risk individuals for pancreatic cancer. (⊕⊕oo)
312101
Title
Role of Endoscopy in the Evaluation and Management of Patients with Solid Pancreatic Neoplasia
Authoring Organization
American Society for Gastrointestinal Endoscopy
Publication Month/Year
January 3, 2016
Last Updated Month/Year
May 31, 2023
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Female, Male, Adult, Older adult
Health Care Settings
Ambulatory, Hospital, Outpatient
Intended Users
Radiology technologist, nurse, nurse practitioner, physician, physician assistant
Scope
Assessment and screening, Diagnosis, Management
Diseases/Conditions (MeSH)
D008223 - Lymphoma, D004724 - Endoscopy, D020776 - Endoscopes, Gastrointestinal, D010182 - Pancreatic Diseases, D009377 - Multiple Endocrine Neoplasia
Keywords
endoscopy, Biliary tract neoplasia, solid pancreatic neoplasia
Source Citation
Eloubeidi, M. A., Decker, G. A., Chandrasekhara, V., Chathadi, K. V., Early, D. S., Evans, J. A., … DeWitt, J. M. (2016). The role of endoscopy in the evaluation and management of patients with solid pancreatic neoplasia. Gastrointestinal Endoscopy, 83(1), 17–28. doi:10.1016/j.gie.2015.09.009
Methodology
Number of Source Documents
140
Literature Search Start Date
January 3, 1975
Literature Search End Date
May 3, 2015