Interventional gastroenterology: esophageal and pancreatic cancers

The development and refinement of endoscopic procedures have greatly improved the diagnosis and management of esophageal and pancreatic cancers. Endoscopic ultrasound (EUS) is a highly accurate technique for TNM staging in esophageal cancer, and allows a tissue diagnosis of lymph nodes via fine-needle aspiration with low risk of complications. Endoscopic mucosal resection is a treatment option in patients with early esophageal cancer who are poor surgical candidates. Similarly, EUS fine-needle aspiration is helpful in establishing a diagnosis in cystic lesions, exocrine tumors, neuroendocrine tumors, and other lesions in the pancreas. Endoscopic retrograde cholangiopancreatography provides diagnostic and therapeutic modalities for various pancreaticobiliary problems. A number of promising EUS-guided therapies for pancreatic cancers are under investigation.