Tratamiento endoscópico de la obstrucción biliar en cáncer de páncreas no resecable

Abstract

Pancreatic cancer is a worldwide health problem. At diagnosis, most of them are not suitable for curative treatment, so they will eventually develop complications such as biliary obstruction, therefore they will require palliative treatment. Endoscopy currently forms the cornerstone in the treatment of malignant biliary obstruction, due to its lower morbidity compared with both percutaneous drainage and surgery. Endoscopic retrograde cholangiopancreatography (ERCP) biliary drainage by using self-expandable metal stent should be considered the first-line treatment. In patients with failed ERCP, endoscopic ultrasound-guided biliary drainage (EUS-BD) ought to be the preferred rescue therapy. Although there is increasing evidence that EUS-BD can replace ERCP for the primary treatment of unresectable pancreatic cancer, further studies are needed.