Skip to main content
SpringerLink
Log in

The Role of Interventional Endoscopy

  • Chapter
  • First Online:
New Concepts in Diagnosis and Therapy of Pancreatic Adenocarcinoma

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

  • 901 Accesses

Abstract

Interventional endoscopy has a key role in the palliation of pancreatic cancer.

Biliary obstruction leading to jaundice and hitching can be safely resolved by endoscopic plastic or metal stenting. Metal stents have a longer patency than plastic, and are cost-effective in patients with 4-6 months life expectancy. Endoscopic palliation of jaundice improves the quality of life, is mini-invasive, safe and effective and is preferred to surgery or interventional radiology. The main problem of biliary stents is cholangitis recurrence due to stent clogging: the development of new drug-eluting stent maybe will improve stent patency in the near future. Also pain in pancreatic cancer can be reduced by endoscopic pancreatic stenting or EUS-guided celiac plexus block/neurolysis in selected cases.

A late complication of pancreatic cancer is the developmant of a duodenal stricture and Gastric Outlet Obstruction Symptoms. This complication, which usually occurs in end-stage and fragile patients, can be resolved by endoscopic insertion of a duodenal metal stents. Duodenal stenting is preferred to surgery due to its lower morbidity and mortality, shorter hospitalization and earlier symptoms relief.

ERCP and EUS are also a tool for intraluminal brachytherapy and delivery of cytotoxic agents directly into the pancreatic tumor. This latest possibility can represent a future approach to pancreatic and other tumors.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Abraham, N.S., Barkun, J.S., Barkun, A.N.: Palliation of malignant biliary obstruction: a prospective trial examining impact on quality of life. Gastrointest Endosc 56, 835–841 (2002)

    PubMed  Google Scholar 

  • Adler, D.G., Baron, T.H.: Endoscopic palliation of malignant gastric outlet obstruction using self-expanding metal stents: experience in 36 patients. Am J Gastroenterol 97, 72–78 (2002)

    PubMed  Google Scholar 

  • Andersen, J.R., Sorensen, S.M., Kruse, A., Rokkjaer, M., Matzen, P.: Randomised trial of endoscopic endoprosthesis versus operative bypass in malignant obstructive jaundice. Gut 30, 1132–1135 (1989)

    PubMed Central  PubMed  CAS  Google Scholar 

  • Arhan, M., Odemis, B., Parlak, E., Ertugrul, I., Basar, O.: Migration of biliary plastic stents: experience of a tertiary center. Surg Endosc 23, 769–775 (2009)

    PubMed  Google Scholar 

  • Artifon, E.L., Sakai, P., Cunha, J.E., Dupont, A., Filho, F.M., Hondo, F.Y., Ishioka, S., Raju, G.S.: Surgery or endoscopy for palliation of biliary obstruction due to metastatic pancreatic cancer. Am J Gastroenterol 101, 2031–2037 (2006)

    PubMed  Google Scholar 

  • Ballinger, A.B., McHugh, M., Catnach, S.M., Alstead, E.M., Clark, M.L.: Symptom relief and quality of life after stenting for malignant bile duct obstruction. Gut 35, 467–470 (1994)

    PubMed Central  PubMed  CAS  Google Scholar 

  • Baron, T.H., Harewood, G.C.: Enteral self-expandable stents. Gastrointest Endosc 58, 421–433 (2003)

    PubMed  Google Scholar 

  • Bessoud, B., de Baere, T., Denys, A., Kuoch, V., Ducreux, M., Precetti, S., Roche, A., Menu, Y.: Malignant gastroduodenal obstruction: palliation with self-expanding metallic stents. J Vasc Interv Radiol 16, 247–253 (2005)

    PubMed  Google Scholar 

  • Bruha, R., Petrtyl, J., Kubecova, M., Marecek, Z., Dufek, V., Urbanek, P., Kodadova, J., Chodounsky, Z.: Intraluminal brachytherapy and selfexpandable stents in nonresectable biliary malignancies – the question of long-term palliation. Hepatogastroenterology 48, 631–637 (2001)

    PubMed  CAS  Google Scholar 

  • Bueno, J.T., Gerdes, H., Kurtz, R.C.: Endoscopic management of occluded biliary Wallstents: A cancer center experience. Gastrointest Endosc 58, 879–884 (2003)

    PubMed  Google Scholar 

  • Catalano, M.F., Geenen, J.E., Lehman, G.A., Siegel, J.H., Jacob, L., McKinley, M.J., Raijman, I., Meier, P., Jacobson, I., Kozarek, R., Al-Kawas, F.H., Lo, S.K., Dua, K.S., Baille, J., Ginsberg, G.G., Parsons, W., Meyerson, S.M., Cohen, S., Nelson, D.B., McHattie, J.D., Carr-Locke, D.L.: “Tannenbaum” Teflon stents versus traditional polyethylene stents for treatment of malignant biliary stricture. Gastrointest Endosc 55, 354–358 (2002)

    PubMed  Google Scholar 

  • Cetta, F., Rappuoli, R., Montalto, G., Baldi, C., Gori, M., Cetta, D., Zuckermann, M., Magnani, A., Barbucci, R.: New biliary endoprosthesis less liable to block in biliary infections: description and in vitro studies. Eur J Surg 165, 782–785 (1999)

    PubMed  CAS  Google Scholar 

  • Chang, K.J., Lee, J.G., Holcombe, R.F., Kuo, J., Muthusamy, R., Wu, M.L.: Endoscopic ultrasound delivery of an antitumor agent to treat a case of pancreatic cancer. Nat Clin Pract Gastroenterol Hepatol 5, 107–111 (2008)

    PubMed  Google Scholar 

  • Chaurasia, O.P., Rauws, E.A., Fockens, P., Huibregtse, K.: Endoscopic techniques for retrieval of proximally migrated biliary stents: the Amsterdam experience. Gastrointest Endosc 50, 780–785 (1999)

    PubMed  CAS  Google Scholar 

  • Chen, J.H., Sun, C.K., Liao, C.S., Chua, C.S.: Self-expandable metallic stents for malignant biliary obstruction: efficacy on proximal and distal tumors. World J Gastroenterol 12, 119–122 (2006)

    PubMed  CAS  Google Scholar 

  • Christiaens, P., Decock, S., Buchel, O., Bulte, K., Moons, V., D’Haens, G., Van, O.G.: Endoscopic trimming of metallic stents with the use of argon plasma. Gastrointest Endosc 67, 369–371 (2008)

    PubMed  Google Scholar 

  • Coates, J.M., Beal, S.H., Russo, J.E., Vanderveen, K.A., Chen, S.L., Bold, R.J., Canter, R.J.: Negligible effect of selective preoperative biliary drainage on perioperative resuscitation, morbidity, and mortality in patients undergoing pancreaticoduodenectomy. Arch Surg 144, 841–847 (2009)

    PubMed  Google Scholar 

  • Costamagna, G., Alevras, P., Palladino, F., Rainoldi, F., Mutignani, M., Morganti, A.: Endoscopic pancreatic stenting in pancreatic cancer. Can J Gastroenterol 13, 481–487 (1999)

    PubMed  CAS  Google Scholar 

  • Costamagna, G., Mutignani, M., Rotondano, G., Cipolletta, L., Ghezzo, L., Foco, A., Zambelli, A.: Hydrophilic hydromer-coated polyurethane stents versus uncoated stents in malignant biliary obstruction: a randomized trial. Gastrointest Endosc 51, 8–11 (2000)

    PubMed  CAS  Google Scholar 

  • Davids, P.H., Groen, A.K., Rauws, E.A., Tytgat, G.N., Huibregtse, K.: Randomised trial of self-expanding metal stents versus polyethylene stents for distal malignant biliary obstruction. Lancet 340, 1488–1492 (1992)

    PubMed  CAS  Google Scholar 

  • Dormann, A., Meisner, S., Verin, N., Wenk, L.A.: Self-expanding metal stents for gastroduodenal malignancies: systematic review of their clinical effectiveness. Endoscopy 36, 543–550 (2004)

    PubMed  CAS  Google Scholar 

  • Dowidar, N., Moesgaard, F., Matzen, P.: Clogging and other complications of endoscopic biliary endoprostheses. Scand J Gastroenterol 26, 1132–1136 (1991)

    PubMed  CAS  Google Scholar 

  • Familiari, P., Bulajic, M., Mutignani, M., Lee, L.S., Spera, G., Spada, C., Tringali, A., Costamagna, G.: Endoscopic removal of malfunctioning biliary self-expandable metallic stents. Gastrointest Endosc 62, 903–910 (2005)

    PubMed  Google Scholar 

  • Ferlitsch, A., Oesterreicher, C., Dumonceau, J.M., Deviere, J., Leban, T., Born, P., Rosch, T., Suter, W., Binek, J., Meyenberger, C., Mullner, M., Schneider, B., Schofl, R.: Diamond stents for palliation of malignant bile duct obstruction: A prospective multicenter evaluation. Endoscopy 33, 645–650 (2001)

    PubMed  CAS  Google Scholar 

  • Freeman, M.L.: Adverse outcomes of ERCP. Gastrointest Endosc 56, S273–S282 (2002)

    PubMed  Google Scholar 

  • Fritz, P., Brambs, H.J., Schraube, P., Freund, U., Berns, C., Wannenmacher, M.: Combined external beam radiotherapy and intraluminal high dose rate brachytherapy on bile duct carcinomas. Int J Radiat Oncol Biol Phys 29, 855–861 (1994)

    PubMed  CAS  Google Scholar 

  • Fumex, F., Coumaros, D., Napoleon, B., Barthet, M., Laugier, R., Yzet, T., Le, S.A., Desurmont, P., Lamouliatte, H., Letard, J.C., Canard, J.M., Prat, F., Rey, J.F., Ponchon, T.: Similar performance but higher cholecystitis rate with covered biliary stents: results from a prospective multicenter evaluation. Endoscopy 38, 787–792 (2006)

    PubMed  CAS  Google Scholar 

  • Gress, F., Schmitt, C., Sherman, S., Ciaccia, D., Ikenberry, S., Lehman, G.: Endoscopic ultrasound-guided celiac plexus block for managing abdominal pain associated with chronic pancreatitis: a prospective single center experience. Am J Gastroenterol 96, 409–416 (2001)

    PubMed  CAS  Google Scholar 

  • Gunaratnam, N.T., Sarma, A.V., Norton, I.D., Wiersema, M.J.: A prospective study of EUS-guided celiac plexus neurolysis for pancreatic cancer pain. Gastrointest Endosc 54, 316–324 (2001)

    PubMed  CAS  Google Scholar 

  • Herzog, T., Belyaev, O., Muller, C.A., Mittelkotter, U., Seelig, M.H., Weyhe, D., Felderbauer, P., Schlottmann, R., Schrader, H., Schmidt, W.E., Uhl, W.: Bacteribilia after preoperative bile duct stenting: a prospective study. J Clin Gastroenterol 43, 457–462 (2009)

    PubMed  Google Scholar 

  • Ho, H., Mahajan, A., Gosain, S., Jain, A., Brock, A., Rehan, M.E., Ellen, K., Shami, V.M., Kahaleh, M.: Management of complications associated with partially covered biliary metal stents. Dig Dis Sci 55, 516–522 (2010)

    PubMed  Google Scholar 

  • Holt, A.P., Patel, M., Ahmed, M.M.: Palliation of patients with malignant gastroduodenal obstruction with self-expanding metallic stents: the treatment of choice? Gastrointest Endosc 60, 1010–1017 (2004)

    PubMed  Google Scholar 

  • Hosono, S., Ohtani, H., Arimoto, Y., Kanamiya, Y.: Endoscopic stenting versus surgical gastroenterostomy for palliation of malignant gastroduodenal obstruction: a meta-analysis. J Gastroenterol 42, 283–290 (2007)

    PubMed  Google Scholar 

  • Huibregtse, K.: Plastic or expandable biliary endoprostheses? Scand J Gastroenterol Suppl 200, 3–7 (1993)

    PubMed  CAS  Google Scholar 

  • Ikeda, H., Kuroda, C., Uchida, H., Miyata, Y., Masaki, N., Shigematsu, Y., Monden, M., Okamura, J.: Intraluminal irradiation with iridium-192 wires for extrahepatic bile duct carcinoma–a preliminary report (author’s transl). Nippon Igaku Hoshasen Gakkai Zasshi 39, 1356–1358 (1979)

    PubMed  CAS  Google Scholar 

  • Isayama, H., Komatsu, Y., Tsujino, T., Sasahira, N., Hirano, K., Toda, N., Nakai, Y., Yamamoto, N., Tada, M., Yoshida, H., Shiratori, Y., Kawabe, T., Omata, M.: A prospective randomised study of “covered” versus “uncovered” diamond stents for the management of distal malignant biliary obstruction. Gut 53, 729–734 (2004)

    PubMed Central  PubMed  CAS  Google Scholar 

  • Isayama, H., Kawabe, T., Nakai, Y., Tsujino, T., Sasahira, N., Yamamoto, N., Arizumi, T., Togawa, O., Matsubara, S., Ito, Y., Sasaki, T., Hirano, K., Toda, N., Komatsu, Y., Tada, M., Yoshida, H., Omata, M.: Cholecystitis after metallic stent placement in patients with malignant distal biliary obstruction. Clin Gastroenterol Hepatol 4, 1148–1153 (2006)

    PubMed  Google Scholar 

  • Isayama, H., Nakai, Y., Toyokawa, Y., Togawa, O., Gon, C., Ito, Y., Yashima, Y., Yagioka, H., Kogure, H., Sasaki, T., Arizumi, T., Matsubara, S., Yamamoto, N., Sasahira, N., Hirano, K., Tsujino, T., Toda, N., Tada, M., Kawabe, T., Omata, M.: Measurement of radial and axial forces of biliary self-expandable metallic stents. Gastrointest Endosc 70, 37–44 (2009)

    PubMed  Google Scholar 

  • Jeurnink, S.M., van Eijck, C.H., Steyerberg, E.W., Kuipers, E.J., Siersema, P.D.: Stent versus gastrojejunostomy for the palliation of gastric outlet obstruction: a systematic review. BMC Gastroenterol 7, 18 (2007a)

    PubMed Central  PubMed  Google Scholar 

  • Jeurnink, S.M., Steyerberg, E.W., Hof, G., van Eijck, C.H., Kuipers, E.J., Siersema, P.D.: Gastrojejunostomy versus stent placement in patients with malignant gastric outlet obstruction: a comparison in 95 patients. J Surg Oncol 96, 389–396 (2007b)

    PubMed  CAS  Google Scholar 

  • Johanson, J.F., Schmalz, M.J., Geenen, J.E.: Incidence and risk factors for biliary and pancreatic stent migration. Gastrointest Endosc 38, 341–346 (1992)

    PubMed  CAS  Google Scholar 

  • Jung, G.S., Song, H.Y., Kang, S.G., Huh, J.D., Park, S.J., Koo, J.Y., Cho, Y.D.: Malignant gastroduodenal obstructions: Treatment by means of a covered expandable metallic stent-initial experience. Radiology 216, 758–763 (2000)

    PubMed  CAS  Google Scholar 

  • Kaassis, M., Boyer, J., Dumas, R., Ponchon, T., Coumaros, D., Delcenserie, R., Canard, J.M., Fritsch, J., Rey, J.F., Burtin, P.: Plastic or metal stents for malignant stricture of the common bile duct? Results of a randomized prospective study. Gastrointest Endosc 57, 178–182 (2003)

    PubMed  Google Scholar 

  • Kahaleh, M., Tokar, J., Conaway, M.R., Brock, A., Le, T., Adams, R.B., Yeaton, P.: Efficacy and complications of covered Wallstents in malignant distal biliary obstruction. Gastrointest Endosc 61, 528–533 (2005)

    PubMed  Google Scholar 

  • Katsinelos, P., Kountouras, J., Paroutoglou, G., Paikos, D., Moschos, J., Chatzimavroudis, G., Zavos, C., Makrigiannis, E.: Uncovered Hanaro versus Luminex metal stents for palliation of malignant biliary strictures. J Clin Gastroenterol 42, 539–545 (2008)

    PubMed  Google Scholar 

  • Kaufman, M., Singh, G., Das, S., Concha-Parra, R., Erber, J., Micames, C., Gress, F.: Efficacy of endoscopic ultrasound-guided celiac plexus block and celiac plexus neurolysis for managing abdominal pain associated with chronic pancreatitis and pancreatic cancer. J Clin Gastroenterol 44, 127–134 (2010)

    PubMed  Google Scholar 

  • Kaw, M., Singh, S., Gagneja, H.: Clinical outcome of simultaneous self-expandable metal stents for palliation of malignant biliary and duodenal obstruction. Surg Endosc 17, 457–461 (2003)

    PubMed  CAS  Google Scholar 

  • Kim, H.S., Lee, D.K., Kim, H.G., Park, J.J., Park, S.H., Kim, J.H., Yoo, B.M., Roe, I.H., Moon, Y.S., Myung, S.J.: Features of malignant biliary obstruction affecting the patency of metallic stents: a multicenter study. Gastrointest Endosc 55, 359–365 (2002)

    PubMed  Google Scholar 

  • Kim, J.H., Song, H.Y., Shin, J.H., Choi, E., Kim, T.W., Jung, H.Y., Lee, G.H., Lee, S.K., Kim, M.H., Ryu, M.H., Kang, Y.K., Kim, B.S., Yook, J.H.: Metallic stent placement in the palliative treatment of malignant gastroduodenal obstructions: prospective evaluation of results and factors influencing outcome in 213 patients. Gastrointest Endosc 66, 256–264 (2007)

    PubMed  Google Scholar 

  • Kocak, Z., Ozkan, H., Adli, M., Garipagaoglu, M., Kurtman, C., Cakmak, A.: Intraluminal brachytherapy with metallic stenting in the palliative treatment of malignant obstruction of the bile duct. Radiat Med 23, 200–207 (2005)

    PubMed  Google Scholar 

  • Laasch, H.U., Martin, D.F., Maetani, I.: Enteral stents in the gastric outlet and duodenum. Endoscopy 37, 74–81 (2005)

    PubMed  Google Scholar 

  • Landoni, N., Wengrower, D., Chopita, N., Goldin, E.: Randomized prospective study to compare the efficiency between standard plastic and polyurethane stents in biliary tract malignant obstruction. Acta Gastroenterol Latinoam 30, 501–504 (2000)

    PubMed  CAS  Google Scholar 

  • Lee, D.K., Kim, H.S., Kim, K.S., Lee, W.J., Kim, H.K., Won, Y.H., Byun, Y.R., Kim, M.Y., Baik, S.K., Kwon, S.O.: The effect on porcine bile duct of a metallic stent covered with a paclitaxel-incorporated membrane. Gastrointest Endosc 61, 296–301 (2005)

    PubMed  Google Scholar 

  • Lee, S.M., Kang, D.H., Kim, G.H., Park, W.I., Kim, H.W., Park, J.H.: Self-expanding metallic stents for gastric outlet obstruction resulting from stomach cancer: a preliminary study with a newly designed double-layered pyloric stent. Gastrointest Endosc 66, 1206–1210 (2007)

    PubMed  Google Scholar 

  • Lermite, E., Pessaux, P., Teyssedou, C., Etienne, S., Brehant, O., Arnaud, J.P.: Effect of preoperative endoscopic biliary drainage on infectious morbidity after pancreatoduodenectomy: a case-control study. Am J Surg 195, 442–446 (2008)

    PubMed  Google Scholar 

  • Leung, J., Rahim, N.: The role of covered self-expandable metallic stents in malignant biliary strictures. Gastrointest Endosc 63, 1001–1003 (2006)

    PubMed  Google Scholar 

  • Leung, J.W., Lau, G.T., Sung, J.J., Costerton, J.W.: Decreased bacterial adherence to silver-coated stent material: an in vitro study. Gastrointest Endosc 38, 338–340 (1992)

    PubMed  CAS  Google Scholar 

  • Levy, M., Rajan, E., Keeney, G., Fletcher, J.G., Topazian, M.: Neural ganglia visualized by endoscopic ultrasound. Am J Gastroenterol 101, 1787–1791 (2006)

    PubMed  Google Scholar 

  • Lillemoe, K.D., Pitt, H.A.: Palliation. Surgical and otherwise. Cancer 78, 605–614 (1996)

    PubMed  CAS  Google Scholar 

  • Lo, C.H., Chung, S., Bohmer, R.D.: A devastating complication: duodenal perforation due to biliary stent migration. Surg Laparosc Endosc Percutan Tech 18, 608–610 (2008)

    PubMed  Google Scholar 

  • Lowe, A.S., Beckett, C.G., Jowett, S., May, J., Stephenson, S., Scally, A., Tam, E., Kay, C.L.: Self-expandable metal stent placement for the palliation of malignant gastroduodenal obstruction: experience in a large, single, UK centre. Clin Radiol 62, 738–744 (2007)

    PubMed  CAS  Google Scholar 

  • Luman, W., Cull, A., Palmer, K.R.: Quality of life in patients stented for malignant biliary obstructions. Eur J Gastroenterol Hepatol 9, 481–484 (1997)

    PubMed  CAS  Google Scholar 

  • Machan, L.: Clinical experience and applications of drug-eluting stents in the noncoronary vasculature, bile duct and esophagus. Adv Drug Deliv Rev 58, 447–462 (2006)

    PubMed  CAS  Google Scholar 

  • Maetani, I., Ukita, T., Inone, H., Yoshida, M., Igarashi, Y., Sakai, Y.: Knitted nitinol stent insertion for various intestinal stenoses with a modified delivery system. Gastrointest Endosc 54, 364–367 (2001)

    PubMed  CAS  Google Scholar 

  • Maetani, I., Tada, T., Shimura, J., Ukita, T., Inoue, H., Igarashi, Y., Hoshi, H., Sakai, Y.: Technical modifications and strategies for stenting gastric outlet strictures using esophageal endoprostheses. Endoscopy 34, 402–406 (2002)

    PubMed  CAS  Google Scholar 

  • Maetani, I., Tada, T., Ukita, T., Inoue, H., Sakai, Y., Nagao, J.: Comparison of duodenal stent placement with surgical gastrojejunostomy for palliation in patients with duodenal obstructions caused by pancreaticobiliary malignancies. Endoscopy 36, 73–78 (2004)

    PubMed  CAS  Google Scholar 

  • Maetani, I., Akatsuka, S., Ikeda, M., Tada, T., Ukita, T., Nakamura, Y., Nagao, J., Sakai, Y.: Self-expandable metallic stent placement for palliation in gastric outlet obstructions caused by gastric cancer: a comparison with surgical gastrojejunostomy. J Gastroenterol 40, 932–937 (2005)

    PubMed  CAS  Google Scholar 

  • Maetani, I., Isayama, H., Mizumoto, Y.: Palliation in patients with malignant gastric outlet obstruction with a newly designed enteral stent: A multicenter study. Gastrointest Endosc 66, 355–360 (2007)

    PubMed  Google Scholar 

  • Matsuda, Y., Shimakura, K., Akamatsu, T.: Factors affecting the patency of stents in malignant biliary obstructive disease: univariate and multivariate analysis. Am J Gastroenterol 86, 843–849 (1991)

    PubMed  CAS  Google Scholar 

  • Menon, K., Barkun, A.: Management of occluded biliary Wallstents. Gastrointest Endosc 49, 403–405 (1999)

    PubMed  CAS  Google Scholar 

  • Mezhir, J.J., Brennan, M.F., Baser, R.E., D’Angelica, M.I., Fong, Y., Dematteo, R.P., Jarnagin, W.R., Allen, P.J.: A matched case-control study of preoperative biliary drainage in patients with pancreatic adenocarcinoma: Routine drainage is not justified. J Gastrointest Surg 13(12), 2163–2169 (2009)

    PubMed  Google Scholar 

  • Mishra, G., Liu, T.F., Frankel, A.E.: Recombinant toxin DAB389EGF is cytotoxic to human pancreatic cancer cells. Expert Opin Biol Ther 3, 1173–1180 (2003)

    PubMed  CAS  Google Scholar 

  • Mittal, A., Windsor, J., Woodfield, J., Casey, P., Lane, M.: Matched study of three methods for palliation of malignant pyloroduodenal obstruction. Br J Surg 91, 205–209 (2004)

    PubMed  CAS  Google Scholar 

  • Moss, A.C., Morris, E., Mac, M.P.: Palliative biliary stents for obstructing pancreatic carcinoma. Cochrane Database Syst Rev 2006;CD004200.

    Google Scholar 

  • Moss, A.C., Morris, E., Leyden, J., MacMathuna, P.: Do the benefits of metal stents justify the costs? A systematic review and meta-analysis of trials comparing endoscopic stents for malignant biliary obstruction. Eur J Gastroenterol Hepatol 19, 1119–1124 (2007)

    PubMed  CAS  Google Scholar 

  • Mutignani, M., Shah, S.K., Morganti, A.G., Perri, V., Macchia, G., Costamagna, G.: Treatment of unresectable pancreatic carcinoma by intraluminal brachytherapy in the duct of Wirsung. Endoscopy 34, 555–559 (2002)

    PubMed  CAS  Google Scholar 

  • Mutignani, M., Tringali, A., Shah, S.G., Perri, V., Familiari, P., Iacopini, F., Spada, C., Costamagna, G.: Combined endoscopic stent insertion in malignant biliary and duodenal obstruction. Endoscopy 39, 440–447 (2007)

    PubMed  CAS  Google Scholar 

  • Mutignani, M., Iacopini, F., Perri, V., Familiari, P., Tringali, A., Spada, C., Ingrosso, M., Costamagna, G.: Endoscopic gallbladder drainage for acute cholecystitis: technical and clinical results. Endoscopy 41, 539–546 (2009)

    PubMed  CAS  Google Scholar 

  • Nakai, Y., Isayama, H., Komatsu, Y., Tsujino, T., Toda, N., Sasahira, N., Yamamoto, N., Hirano, K., Tada, M., Yoshida, H., Kawabe, T., Omata, M.: Efficacy and safety of the covered Wallstent in patients with distal malignant biliary obstruction. Gastrointest Endosc 62, 742–748 (2005)

    PubMed  Google Scholar 

  • Ornellas, L.C., Stefanidis, G., Chuttani, R., Gelrud, A., Kelleher, T.B., Pleskow, D.K.: Covered Wallstents for palliation of malignant biliary obstruction: Primary stent placement versus reintervention. Gastrointest Endosc 70, 676–683 (2009)

    PubMed  Google Scholar 

  • Park, D.H., Kim, M.H., Choi, J.S., Lee, S.S., Seo, D.W., Kim, J.H., Han, J., Kim, J.C., Choi, E.K., Lee, S.K.: Covered versus uncovered wallstent for malignant extrahepatic biliary obstruction: a cohort comparative analysis. Clin Gastroenterol Hepatol 4, 790–796 (2006)

    Google Scholar 

  • Pausawasdi, N., Scheiman, J.: Endoscopic evaluation and palliation of pancreatic adenocarcinoma: current and future options. Curr Opin Gastroenterol 23, 515–521 (2007)

    PubMed  Google Scholar 

  • Pedersen, F.M.: Endoscopic management of malignant biliary obstruction. Is stent size of 10 French gauge better than 7 French gauge? Scand J Gastroenterol 28, 185–189 (1993)

    PubMed  CAS  Google Scholar 

  • Perdue, D.G., Freeman, M.L., DiSario, J.A., Nelson, D.B., Fennerty, M.B., Lee, J.G., Overby, C.S., Ryan, M.E., Bochna, G.S., Snady, H.W., Moore, J.P.: Plastic versus self-expanding metallic stents for malignant hilar biliary obstruction: A prospective multicenter observational cohort study. J Clin Gastroenterol 42, 1040–1046 (2008)

    PubMed  Google Scholar 

  • Piesman, M., Kozarek, R.A., Brandabur, J.J., Pleskow, D.K., Chuttani, R., Eysselein, V.E., Silverman, W.B., Vargo, J.J., Waxman, I., Catalano, M.F., Baron, T.H., Parsons III, W.G., Slivka, A., Carr-Locke, D.L.: Improved oral intake after palliative duodenal stenting for malignant obstruction: a prospective multicenter clinical trial. Am J Gastroenterol 104, 2404–2411 (2009)

    PubMed  Google Scholar 

  • Raijman, I.: Biliary and pancreatic stents. Gastrointest Endosc Clin North Am 13, 561–592 (2003)

    Google Scholar 

  • Rogart, J.N., Boghos, A., Rossi, F., Al-Hashem, H., Siddiqui, U.D., Jamidar, P., Aslanian, H.: Analysis of endoscopic management of occluded metal biliary stents at a single tertiary care center. Gastrointest Endosc 68, 676–682 (2008)

    PubMed  Google Scholar 

  • Sarr, M.G., Cameron, J.L.: Surgical management of unresectable carcinoma of the pancreas. Surgery 91, 123–133 (1982)

    PubMed  CAS  Google Scholar 

  • Schiefke, I., Zabel-Langhennig, A., Wiedmann, M., Huster, D., Witzigmann, H., Mossner, J., Berr, F., Caca, K.: Self-expandable metallic stents for malignant duodenal obstruction caused by biliary tract cancer. Gastrointest Endosc 58, 213–219 (2003)

    PubMed  Google Scholar 

  • Schilling, D., Rink, G., Arnold, J.C., Benz, C., Adamek, H.E., Jakobs, R., Riemann, J.F.: Prospective, randomized, single-center trial comparing 3 different 10F plastic stents in malignant mid and distal bile duct strictures. Gastrointest Endosc 58, 54–58 (2003)

    PubMed  Google Scholar 

  • Schmassmann, A., von Gunten, E., Knuchel, J., Scheurer, U., Fehr, H.F., Halter, F.: Wallstents versus plastic stents in malignant biliary obstruction: effects of stent patency of the first and second stent on patient compliance and survival. Am J Gastroenterol 91, 654–659 (1996)

    PubMed  CAS  Google Scholar 

  • Shah, R.J., Howell, D.A., Desilets, D.J., Sheth, S.G., Parsons, W.G., Okolo III, P., Lehman, G.A., Sherman, S., Baillie, J., Branch, M.S., Pleskow, D., Chuttani, R., Bosco, J.J.: Multicenter randomized trial of the spiral Z-stent compared with the Wallstent for malignant biliary obstruction. Gastrointest Endosc 57, 830–836 (2003)

    PubMed  Google Scholar 

  • Shepherd, H.A., Royle, G., Ross, A.P., Diba, A., Arthur, M., Colin-Jones, D.: Endoscopic biliary endoprosthesis in the palliation of malignant obstruction of the distal common bile duct: a randomized trial. Br J Surg 75, 1166–1168 (1988)

    PubMed  CAS  Google Scholar 

  • Shin, H.S., Seong, J., Kim, W.C., Lee, H.S., Moon, S.R., Lee, I.J., Lee, K.K., Park, K.R., Suh, C.O., Kim, G.E.: Combination of external beam irradiation and high-dose-rate intraluminal brachytherapy for inoperable carcinoma of the extrahepatic bile ducts. Int J Radiat Oncol Biol Phys 57, 105–112 (2003)

    PubMed  Google Scholar 

  • Siddiqui, A., Spechler, S.J., Huerta, S.: Surgical bypass versus endoscopic stenting for malignant gastroduodenal obstruction: a decision analysis. Dig Dis Sci 52, 276–281 (2007)

    PubMed  Google Scholar 

  • Simmons, D.T., Petersen, B.T., Gostout, C.J., Levy, M.J., Topazian, M.D., Baron, T.H.: Risk of pancreatitis following endoscopically placed large-bore plastic biliary stents with and without biliary sphincterotomy for management of postoperative bile leaks. Surg Endosc 22, 1459–1463 (2008)

    PubMed  CAS  Google Scholar 

  • Smith, A.C., Dowsett, J.F., Russell, R.C., Hatfield, A.R., Cotton, P.B.: Randomised trial of endoscopic stenting versus surgical bypass in malignant low bileduct obstruction. Lancet 344, 1655–1660 (1994)

    PubMed  CAS  Google Scholar 

  • Soderlund, C., Linder, S.: Covered metal versus plastic stents for malignant common bile duct stenosis: a prospective, randomized, controlled trial. Gastrointest Endosc 63, 986–995 (2006)

    PubMed  Google Scholar 

  • Soehendra, N., Maydeo, A., Eckmann, B., Bruckner, M., Nam, V.C., Grimm, H.: A new technique for replacing an obstructed biliary endoprosthesis. Endoscopy 22, 271–272 (1990)

    PubMed  CAS  Google Scholar 

  • Song, H.Y., Yang, D.H., Kuh, J.H., Choi, K.C.: Obstructing cancer of the gastric antrum: Palliative treatment with covered metallic stents. Radiology 187, 357–358 (1993)

    PubMed  CAS  Google Scholar 

  • Speer, A.G., Cotton, P.B., Russell, R.C., Mason, R.R., Hatfield, A.R., Leung, J.W., MacRae, K.D., Houghton, J., Lennon, C.A.: Randomised trial of endoscopic versus percutaneous stent insertion in malignant obstructive jaundice. Lancet 2, 57–62 (1987)

    PubMed  CAS  Google Scholar 

  • Stawowy, M., Kruse, A., Mortensen, F.V., Funch-Jensen, P.: Endoscopic stenting for malignant gastric outlet obstruction. Surg Laparosc Endosc Percutan Tech 17, 5–9 (2007)

    PubMed  Google Scholar 

  • Stoeckel, D., Pelton, A., Duerig, T.: Self-expanding nitinol stents: material and design considerations. Eur Radiol 14, 292–301 (2004)

    PubMed  Google Scholar 

  • Storkson, R.H., Edwin, B., Reiertsen, O., Faerden, A.E., Sortland, O., Rosseland, A.R.: Gut perforation caused by biliary endoprosthesis. Endoscopy 32, 87–89 (2000)

    PubMed  CAS  Google Scholar 

  • Suk, K.T., Kim, J.W., Kim, H.S., Baik, S.K., Oh, S.J., Lee, S.J., Kim, H.G., Lee, D.H., Won, Y.H., Lee, D.K.: Human application of a metallic stent covered with a paclitaxel-incorporated membrane for malignant biliary obstruction: multicenter pilot study. Gastrointest Endosc 66, 798–803 (2007)

    PubMed  Google Scholar 

  • Sunpaweravong, S., Ovartlarnporn, B., Khow-ean, U., Soontrapornchai, P., Charoonratana, V.: Endoscopic stenting versus surgical bypass in advanced malignant distal bile duct obstruction: cost-effectiveness analysis. Asian J Surg 28, 262–265 (2005)

    PubMed  Google Scholar 

  • Telford, J.J., Carr-Locke, D.L., Baron, T.H., Tringali, A., Parsons, W.G., Gabbrielli, A., Costamagna, G.: Palliation of patients with malignant gastric outlet obstruction with the enteral Wallstent: outcomes from a multicenter study. Gastrointest Endosc 60, 916–920 (2004)

    PubMed  Google Scholar 

  • Tham, T.C., Carr-Locke, D.L., Vandervoort, J., Wong, R.C., Lichtenstein, D.R., Van, D.J., Ruymann, F., Chow, S., Bosco, J.J., Qaseem, T., Howell, D., Pleskow, D., Vannerman, W., Libby, E.D.: Management of occluded biliary Wallstents. Gut 42, 703–707 (1998)

    PubMed Central  PubMed  CAS  Google Scholar 

  • Tham, T.C., Lichtenstein, D.R., Vandervoort, J., Wong, R.C., Slivka, A., Banks, P.A., Yim, H.B., Carr-Locke, D.L.: Pancreatic duct stents for “obstructive type” pain in pancreatic malignancy. Am J Gastroenterol 95, 956–960 (2000)

    PubMed  CAS  Google Scholar 

  • Topazian, M., Baron, T.H.: Endoscopic fenestration of duodenal stents using argon plasma to facilitate ERCP. Gastrointest Endosc 69, 166–169 (2009)

    PubMed  Google Scholar 

  • Tringali, A., Mutignani, M., Perri, V., Zuccala, G., Cipolletta, L., Bianco, M.A., Rotondano, G., Philipper, M., Schumacher, B., Neuhaus, H., Schmit, A., Deviere, J., Costamagna, G.: A prospective, randomized multicenter trial comparing double layer and polyethylene stents for malignant distal common bile duct strictures. Endoscopy 35, 992–997 (2003)

    PubMed  CAS  Google Scholar 

  • Truong, S., Bohndorf, V., Geller, H., Schumpelick, V., Gunther, R.W.: Self-expanding metal stents for palliation of malignant gastric outlet obstruction. Endoscopy 24, 433–435 (1992)

    PubMed  CAS  Google Scholar 

  • van Berkel, A.M., Boland, C., Redekop, W.K., Bergman, J.J., Groen, A.K., Tytgat, G.N., Huibregtse, K.: A prospective randomized trial of Teflon versus polyethylene stents for distal malignant biliary obstruction. Endoscopy 30, 681–686 (1998)

    PubMed  Google Scholar 

  • van Berkel, A.M., van Marle, J., Groen, A.K., Bruno, M.J.: Mechanisms of biliary stent clogging: confocal laser scanning and scanning electron microscopy. Endoscopy 37, 729–734 (2005)

    PubMed  Google Scholar 

  • van Hooft, J., Mutignani, M., Repici, A., Messmann, H., Neuhaus, H., Fockens, P.: First data on the palliative treatment of patients with malignant gastric outlet obstruction using the WallFlex enteral stent: a retrospective multicenter study. Endoscopy 39, 434–439 (2007)

    PubMed  Google Scholar 

  • van Steenbergen, W., van Aken, L., Ponette, E.: Acute pancreatitis complicating the insertion of a self-expandable biliary metal stent. Endoscopy 24, 440–442 (1992)

    PubMed  Google Scholar 

  • Wang, Q., Gurusamy, K.S., Lin, H., Xie, X., Wang, C.: Preoperative biliary drainage for obstructive jaundice. Cochrane Database Syst Rev 2008;CD005444.

    Google Scholar 

  • Warshaw, A.L., Fernandez-del, C.C.: Pancreatic carcinoma. N Engl J Med 326, 455–465 (1992)

    PubMed  CAS  Google Scholar 

  • Watanapa, P., Williamson, R.C.: Surgical palliation for pancreatic cancer: developments during the past two decades. Br J Surg 79, 8–20 (1992)

    PubMed  CAS  Google Scholar 

  • Weber, A., Mittermeyer, T., Wagenpfeil, S., Schmid, R.M., Prinz, C.: Self-expanding metal stents versus polyethylene stents for palliative treatment in patients with advanced pancreatic cancer. Pancreas 38, e7–e12 (2009)

    PubMed  CAS  Google Scholar 

  • Weickert, U., Zimmerling, S., Eickhoff, A., Riemann, J.F., Reiss, G.: A comparative scanning electron microscopic study of biliary and pancreatic stents. Z Gastroenterol 47, 347–350 (2009)

    PubMed  CAS  Google Scholar 

  • Wiersema, M.J., Wiersema, L.M.: Endosonography-guided celiac plexus neurolysis. Gastrointest Endosc 44, 656–662 (1996)

    PubMed  CAS  Google Scholar 

  • Wong, Y.T., Brams, D.M., Munson, L., Sanders, L., Heiss, F., Chase, M., Birkett, D.H.: Gastric outlet obstruction secondary to pancreatic cancer: Surgical vs endoscopic palliation. Surg Endosc 16, 310–312 (2002)

    PubMed  CAS  Google Scholar 

  • Yan, B.M., Myers, R.P.: Neurolytic celiac plexus block for pain control in unresectable pancreatic cancer. Am J Gastroenterol 102, 430–438 (2007)

    PubMed  Google Scholar 

  • Yang, K.Y., Ryu, J.K., Seo, J.K., Woo, S.M., Park, J.K., Kim, Y.T., Yoon, Y.B.: A comparison of the Niti-D biliary uncovered stent and the uncovered Wallstent in malignant biliary obstruction. Gastrointest Endosc 70, 45–51 (2009)

    PubMed  Google Scholar 

  • Yeoh, K.G., Zimmerman, M.J., Cunningham, J.T., Cotton, P.B.: Comparative costs of metal versus plastic biliary stent strategies for malignant obstructive jaundice by decision analysis. Gastrointest Endosc 49, 466–471 (1999)

    PubMed  CAS  Google Scholar 

  • Yim, H.B., Jacobson, B.C., Saltzman, J.R., Johannes, R.S., Bounds, B.C., Lee, J.H., Shields, S.J., Ruymann, F.W., Van, D.J., Carr-Locke, D.L.: Clinical outcome of the use of enteral stents for palliation of patients with malignant upper GI obstruction. Gastrointest Endosc 53, 329–332 (2001)

    PubMed  CAS  Google Scholar 

  • Yoon, W.J., Lee, J.K., Lee, K.H., Lee, W.J., Ryu, J.K., Kim, Y.T., Yoon, Y.B.: A comparison of covered and uncovered Wallstents for the management of distal malignant biliary obstruction. Gastrointest Endosc 63, 996–1000 (2006)

    PubMed  Google Scholar 

  • Yoon, W.J., Ryu, J.K., Yang, K.Y., Paik, W.H., Lee, J.K., Woo, S.M., Park, J.K., Kim, Y.T., Yoon, Y.B.: A comparison of metal and plastic stents for the relief of jaundice in unresectable malignant biliary obstruction in Korea: an emphasis on cost-effectiveness in a country with a low ERCP cost. Gastrointest Endosc 70, 284–289 (2009)

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Digestive Endoscopy Unit, Gemelli University Hospital, Università Cattolica del Sacro Cuore, Largo Gemelli 8, 00167, Rome, Italy

    Guido Costamagna, Pietro Familiari, Andrea Tringali & Ivo Boškoski

Authors
  1. Guido Costamagna
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pietro Familiari
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andrea Tringali
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ivo Boškoski
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. , Radiological, Oncological, and Pathologi, Sapienza , Università di Roma, Polo Pontino, Latina, Italy

    Andrea Laghi

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Costamagna, G., Familiari, P., Tringali, A., Boškoski, I. (2010). The Role of Interventional Endoscopy. In: Laghi, A. (eds) New Concepts in Diagnosis and Therapy of Pancreatic Adenocarcinoma. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2010_60

Download citation

  • DOI: https://doi.org/10.1007/174_2010_60

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-85380-0

  • Online ISBN: 978-3-540-85381-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation