Therapeutic endoscopy permits many and various treatments for cancer palliation in patients with bilio-pancreatic cancers, enabling different options, supporting patients during their route to oncologic treatments, and trying to improve their quality of life. Therefore, both endoscopic and endoscopic ultrasound (EUS)-guided techniques are performed in this scenario. We performed a literature review focusing on the role of endoscopy in the palliation of those advanced pancreatic and biliary cancers developing malignant biliary obstruction (MBO), gastric outlet obstruction (GOO), and pain unresponsive to medical therapies. Therefore, we explored and focused on the clinical outcomes of endoscopic procedures in this scenario. In fact, the endoscopic treatment is based on achieving biliary drainage in the case of MBO through endoscopic retrograde cholangiopancreatography (ERCP) or EUS-guided biliary drainage (EUS-BD), while GOO is endoscopically treated through the deployment of an enteral stent or the creation of EUS-guided gastro-entero-anastomosis (EUS-GEA). Furthermore, untreatable chronic abdominal pain is a major issue in patients unresponsive to high doses of painkillers, so EUS-guided celiac plexus neurolysis (CPN) or celiac ganglia neurolysis (CGN) helps to reduce dosage and have better pain control. Therefore, therapeutic endoscopy in the palliative setting is an effective and safe approach for managing most of the clinical manifestations of advanced biliopancreatic tumors.
治疗性内镜技术为胆胰癌患者的姑息治疗提供了多种多样的治疗手段，不仅拓展了治疗选择，还能在患者接受肿瘤治疗过程中提供支持，并致力于改善其生活质量。因此，内镜及超声内镜引导下的技术在此领域均得到广泛应用。本文通过文献综述，重点探讨内镜在晚期胰腺癌和胆管癌姑息治疗中的作用，特别是针对恶性胆道梗阻、胃出口梗阻及药物难治性疼痛的病例。我们系统梳理并聚焦于内镜治疗在此类临床情境中的实际疗效。具体而言，针对恶性胆道梗阻的内镜治疗主要通过内镜逆行胰胆管造影术或超声内镜引导下胆道引流术实现胆道引流；而胃出口梗阻则通过植入肠道支架或建立超声内镜引导下胃空肠吻合术进行内镜干预。此外，对于大剂量止痛药无效的难治性慢性腹痛患者，超声内镜引导下腹腔神经丛阻滞术或腹腔神经节阻滞术能有效降低药物剂量并提升疼痛控制效果。综上所述，在姑息治疗领域，治疗性内镜技术是处理晚期胆胰肿瘤多数临床表现的安全有效方法。
肿瘤(癌症)患者之家