Feasibility of combined EUS-FNA and ERCP for obstructive jaundice from presumed pancreatic malignancy

The management of patients with pancreatic cancer begins with confirmation of the diagnosis by cytology, which is followed by accurate preoperative staging and biliary drainage. Endoscopic ultrasonography with fine-needle aspiration (EUS-FNA) followed by endoscopic retrograde cholangiopancreatography (ERCP) helps to achieve these goals and primes the patient for various treatment options. We discuss the findings of a study by Ross and colleagues that aimed to determine the feasibility and outcomes of combining EUS-FNA and therapeutic ERCP in a single session. The authors concluded that combined EUS-FNA and ERCP was technically feasible, and could safely and effectively achieve a diagnosis and biliary drainage. The adverse event rate was acceptable; pancreatitis was the most common complication. Such a one-step approach is, therefore, beneficial and calls for the founding of well-equipped units with adequately skilled endoscopy and support staff.