Endoscopic workup in pancreatic cancer

Pancreatic cancer is a highly lethal disease with a rising incidence. It is projected to become the second-leading cause of cancer-related mortality by 2030. The staging of pancreatic cancer can be broadly categorized into three groups: resectable cancers, locally advanced or borderline resectable cancers, and metastatic cancers. Endoscopy plays a crucial role in the management of pancreatic cancer for the establishment of the diagnosis, for the palliation of symptoms due to biliary and/or gastric outlet obstructions, and more recently, for the palliative ablation of cancer. The objective of this review is to provide an overview of the endoscopic evaluation and management of patients with pancreatic cancer. It will specifically cover the diagnostic approach utilizing endoscopic ultrasound, palliative interventions such as endoscopic retrograde cholangiopancreatography, and the emerging field of tumor debulking through radiofrequency ablation.