EUS-Guided Bypass Procedures to Maintain Quality of Life in Advanced Pancreatic Adenocarcinoma (PAC)

Abstract Text Palliative chemotherapy extends survival in PAC, but complications often limit options like ERCP or surgery. A patient with locally advanced PAC received neoadjuvant gemcitabine-paclitaxel, radiotherapy, and folfirinox. Obstructive jaundice was managed for 14 months with ERCP and stenting. Refractory pain and bile duct dilation required EUS-guided double drainage, followed by celiac plexus neurolysis for partial relief. Six months later, EUS-guided gastrojejunostomy addressed a duodenal stricture. Fourteen months later, cholangitis was treated with EUS-guided hepaticogastrostomy and stenting. All minimally invasive procedures were uneventful, with brief hospital stays. The patient maintained quality of life and autonomy, surviving three years post-diagnosis before passing away. This case highlights the efficacy of sequential EUS-guided procedures for symptom management in advanced PAC [1].

Video  http://data.process.y-congress.com/ScientificProcess/Data//106/570/1428/eba4111e-ea5f-40aa-813e-d08517fe0afd/Uploads/16849_V%C3%ADdeo_ADC%20derivaciones%20ESGE%2025.mp4

 

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Conflicts of Interest

Authors do not have any conflict of interest to disclose.

• References

• 1 Vanella G, Leone R, Frigo F, Bronswijk M, van Wanrooij RLJ, Tamburrino D, Orsi G, Belfiori G, Macchini M, Reni M, Aldrighetti L, Falconi M, Capurso G, van der Merwe S, Arcidiacono PG.. Endoscopic ultrasound-guided choledochoduodenostomy versus hepaticogastrostomy combined with gastroenterostomy in malignant double obstruction (CABRIOLET_Pro): A prospective comparative study. DEN Open 2024; 5 (1): e70024

Publication History

Article published online:
27 March 2025