The Role of Endoscopy in Pancreatic Disease: Evolution, Clinical Efficacy, and Future Directions

Background

Over the past decade, the role of endoscopy in pancreatic disease has undergone significant evolution. Endoscopic ultrasound-guided tissue acquisition (EUS-TA) for solid pancreatic lesions has evolved from fine-needle aspiration (FNA) cytology to fine-needle biopsy (FNB) histology. With progressive improvements in needle design and sampling techniques, EUS-TA now provides high diagnostic accuracy with an excellent adverse event profile. Recent developments have enabled a shift towards the procurement of high-quality tissue for molecular profiling including next-generation sequencing and organoid generation. Ongoing innovations signal a promising future, with the development of more advanced EUS imaging, further technical EUS-TA improvements and digital pathology/AI, which should enable the prescription of personalized therapy for patients with pancreatic malignancy.

Moreover, endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound have developed from primarily diagnostic modalities to minimally invasive therapeutic tools. EUS-guided cystgastrostomy is now the preferred modality for drainage of pancreatic cysts. Other therapeutic interventions present an alternative for high-risk surgical patients, with comparable efficacy and improved safety. The integration of ERCP and EUS with digital imaging, robotics, and artificial intelligence promises to further increase precision and expand the role of these procedures. These developments are redefining the landscape of endoscopy in pancreatic disease, minimizing morbidity, mortality and improving patient outcomes.



Call for Papers

We invite submissions that examine the development, clinical effectiveness, and prospective advancements of endoscopic approaches in pancreatic disease.

Topics of Interest Include:

ERCP in benign and malignant pancreatic disease, including pancreatoscopy and related techniques

Diagnostic EUS in pancreatic disease, including tissue acquisition and artificial intelligence

Therapeutic EUS in pancreatic disease, including drainage procedures, fine-needle injection, ablation, fiducial implantation, brachytherapy, coeliac-plexus block and neurolysis.