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. (⊕⊕⊕⊕)
312101
We recommend that EUS be performed for evaluation of pancreatic masses and suspected malignancy, particularly when CT detection or evaluation of resectability is equivocal. (⊕⊕⊕⊕)
312101
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. (⊕⊕⊕⊕)
312101
We suggest that EUS-guided celiac plexus neurolysis be considered in patients with pancreatic cancer–related pain. (⊕⊕⊕o)
312101
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)
312101
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)
312101
We recommend EUS ± FNA for localization and characterization of suspected pancreatic neuroendocrine tumors and metastatic solid pancreatic neoplasia. (⊕⊕⊕o)
312101
We suggest EUS-guided fiducial placement into a pancreatic malignancy if image-guided radiation therapy is considered. (⊕⊕⊕o)
312101
We suggest that screening with EUS and MRCP should be offered to high-risk individuals for pancreatic cancer. (⊕⊕oo)
312101

Recommendation Grading

Overview

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

Document Type

Guideline

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