Endoscopic Ultrasound-Guided Locoregional Treatments for Solid Pancreatic Neoplasms

SIMPLE SUMMARY: Endoscopic ultrasound-guided locoregional treatments actually represent a leading role in the majority of solid pancreatic neoplasms, with the aim to combine with optimal management of clinical symptoms for a better quality of life. Recently, several endoscopic ultrasound-guided locoregional treatment techniques for solid pancreatic neoplasms (especially thermal ablative techniques and non-thermal injection techniques) have been developed. The focus of this review is to update evidence about the efficacy and safety of endoscopic ultrasound-guided locoregional treatments in solid pancreatic neoplasms. ABSTRACT: Solid pancreatic neoplasms are one of the most diagnosed gastrointestinal malignancies thanks to the current and progressive advances in radiologic methods. Endoscopic ultrasound-guided techniques have over time gained a prominent role in the differential diagnosis and characterization of these pancreatic lesions, including pancreatic cancer, neuroendocrine tumors, and metastases. Recently, several endoscopic ultrasound-guided locoregional treatment techniques, which are divided into thermal ablative techniques and non-thermal injection techniques, have been developed and applied in different settings for the treatment of solid pancreatic neoplasms. The most common ablative techniques are radiofrequency, microwave, laser, photodynamic therapy and hybrid techniques such as hybrid cryothermal ablation. The most common injection techniques are ethanol injection, immunotherapy and brachytherapy. In this review, we update evidence about the efficacy and safety of endoscopic ultrasound-guided locoregional treatments for solid pancreatic neoplasms.