Endoscopic ultrasound in the diagnosis and staging of pancreatic cancer

Patients with signs and symptoms suggestive of a pancreatic neoplasm typically undergo initial imaging with transabdominal ultrasound or computed tomography. This evaluation often reveals the presence of a pancreatic mass or fullness. At times, the nature of the lesion is poorly characterized, with uncertainty remaining as to whether the lesion is an inflammatory mass or a neoplasm, and if it is cystic or solid. In these circumstances, endoscopic procedures such as endoscopic retrograde cholangiopancreatography and/or endoscopic ultrasound may be required. These procedures offer other means of tissue sampling, disease staging, and an option for palliative therapy. In this article, we review the role of endoscopy for the diagnosis and staging of pancreatic tumors, with a particular focus on endoscopic ultrasound.