What can the Interventional Endoscopist Offer in the Management of Upper Gastrointestinal Malignancies?

K Basiliya; P Pang; J Honing; M di Pietro; S Varghese; E Gbegli; G Corbett; N R Carroll; E M Godfrey

doi:10.1016/j.clon.2023.05.004

What can the Interventional Endoscopist Offer in the Management of Upper Gastrointestinal Malignancies?

Clin Oncol (R Coll Radiol). 2023 May 18:S0936-6555(23)00183-8. doi: 10.1016/j.clon.2023.05.004. Online ahead of print.

Authors

K Basiliya¹, P Pang², J Honing³, M di Pietro³, S Varghese², E Gbegli⁴, G Corbett², N R Carroll⁴, E M Godfrey⁴

Affiliations

¹ Department of Gastroenterology, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK. Electronic address: k.basiliya@nhs.net.
² Department of Gastroenterology, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK.
³ Early Cancer Institute, University of Cambridge, Cambridge, UK.
⁴ Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK.

PMID: 37253647
DOI: 10.1016/j.clon.2023.05.004

Abstract

The therapeutic possibilities of endoscopy have rapidly increased in the last decades and now allow organ-sparing treatment of early upper gastrointestinal malignancy as well as an increasing number of options for symptom palliation. This review contains an overview of the interventional endoscopic procedures in upper gastrointestinal malignancies. It describes endoscopic treatment of early oesophageal and gastric cancers, and the palliative options in managing dysphagia and gastric outlet obstruction. It also provides an overview of the therapeutic possibilities of biliary endoscopy, such as retrograde stenting and radiofrequency biliary ablation. Endoscopic ultrasound-guided therapeutic options are discussed, including biliary drainage, gastrojejunostomy and coeliac axis block. To aid in clinical decision making, the procedures are described in the context of their indication, efficacy, risks and limitations.

Keywords: Endoscopic resection; malignant obstruction; oesophageal cancer; palliation; pancreatic cancer; stenting.