Skip to main content
SpringerLink
Log in

EUS and Its Role in Pancreatic Cancer

  • Living reference work entry
  • First Online:
Pancreatic Cancer

  • 152 Accesses

Abstract

Endosocopic ultrasound (EUS) has become an indispensable tool in pancreatic diseases especially in cancer. This article provides an overview about basic principles as well as current developments in the field. It reviews recent literature regarding the use of EUS in pancreatic cancer. The key focus is on EUS-guided tissue sampling by EUS-fine-needle aspiration (EUS-FNA). Further main aspects include cystic pancreatic neoplasias, screening of individuals at risk for familial pancreatic cancer, and EUS-guided therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

Similar content being viewed by others

References

  1. Committee ASoP, Eloubeidi MA, Decker GA, Chandrasekhara V, Chathadi KV, Early DS, et al. The role of endoscopy in the evaluation and management of patients with solid pancreatic neoplasia. Gastrointest Endosc. 2016;83(1):17–28.

    Article  Google Scholar 

  2. Committee AT, Murad FM, Komanduri S, Abu Dayyeh BK, Chauhan SS, Enestvedt BK, et al. Echoendoscopes. Gastrointest Endosc. 2015;82(2):189–202.

    Article  Google Scholar 

  3. Shin EJ, Topazian M, Goggins MG, Syngal S, Saltzman JR, Lee JH, et al. Linear-array EUS improves detection of pancreatic lesions in high-risk individuals: a randomized tandem study. Gastrointest Endosc. 2015;82(5):812–8.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Hawes RHFP, Varadarajulu S. Endosonography. 3rd ed. Oxford: Elsevier Ltd; 2014.

    Google Scholar 

  5. Aslanian H, Salem R, Lee J, Andersen D, Robert M, Topazian M. EUS diagnosis of vascular invasion in pancreatic cancer: surgical and histologic correlates. Am J Gastroenterol. 2005;100(6):1381–5.

    Article  PubMed  Google Scholar 

  6. DeWitt J, Devereaux B, Chriswell M, McGreevy K, Howard T, Imperiale TF, et al. Comparison of endoscopic ultrasonography and multidetector computed tomography for detecting and staging pancreatic cancer. Ann Intern Med. 2004;141(10):753–63.

    Article  PubMed  Google Scholar 

  7. Dewitt J, Devereaux BM, Lehman GA, Sherman S, Imperiale TF. Comparison of endoscopic ultrasound and computed tomography for the preoperative evaluation of pancreatic cancer: a systematic review. Clin Gastroenterol Hepatol. 2006;4(6):717–725. quiz 664.

    Google Scholar 

  8. Fisher JM, Gordon SR, Gardner TB. The impact of prior biliary stenting on the accuracy and complication rate of endoscopic ultrasound fine-needle aspiration for diagnosing pancreatic adenocarcinoma. Pancreas. 2011;40(1):21–4.

    Article  PubMed  Google Scholar 

  9. Chang KJ, Albers CG, Erickson RA, Butler JA, Wuerker RB, Lin F. Endoscopic ultrasound-guided fine needle aspiration of pancreatic carcinoma. Am J Gastroenterol. 1994;89(2):263–6.

    CAS  PubMed  Google Scholar 

  10. Wiersema MJ, Vilmann P, Giovannini M, Chang KJ, Wiersema LM. Endosonography-guided fine-needle aspiration biopsy: diagnostic accuracy and complication assessment. Gastroenterology. 1997;112(4):1087–95.

    Article  CAS  PubMed  Google Scholar 

  11. Hartwig W, Schneider L, Diener MK, Bergmann F, Buchler MW, Werner J. Preoperative tissue diagnosis for tumours of the pancreas. Br J Surg. 2009;96(1):5–20.

    Article  CAS  PubMed  Google Scholar 

  12. Seufferlein T, Porzner M, Becker T, Budach V, Ceyhan G, Esposito I, et al. S3-guideline exocrine pancreatic cancer. Z Gastroenterol. 2013;51(12):1395–440.

    Article  CAS  PubMed  Google Scholar 

  13. Shimosegawa T, Chari ST, Frulloni L, Kamisawa T, Kawa S, Mino-Kenudson M, et al. International consensus diagnostic criteria for autoimmune pancreatitis: guidelines of the international association of pancreatology. Pancreas. 2011;40(3):352–8.

    Article  PubMed  Google Scholar 

  14. Tanaka M, Fernandez-del Castillo C, Adsay V, Chari S, Falconi M, Jang JY, et al. International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas. Pancreatology. 2012;12(3):183–97.

    Article  PubMed  Google Scholar 

  15. Crane CH, Varadhachary G, Wolff RA, Pisters PW, Evans DB. The argument for pre-operative chemoradiation for localized, radiographically resectable pancreatic cancer. Best Pract Res Clin Gastroenterol. 2006;20(2):365–82.

    Article  PubMed  Google Scholar 

  16. Eloubeidi MA, Chen VK, Eltoum IA, Jhala D, Chhieng DC, Jhala N, et al. Endoscopic ultrasound-guided fine needle aspiration biopsy of patients with suspected pancreatic cancer: diagnostic accuracy and acute and 30-day complications. Am J Gastroenterol. 2003;98(12):2663–8.

    PubMed  Google Scholar 

  17. Lai R, Stanley MW, Bardales R, Linzie B, Mallery S. Endoscopic ultrasound-guided pancreatic duct aspiration: diagnostic yield and safety. Endoscopy. 2002;34(9):715–20.

    Article  CAS  PubMed  Google Scholar 

  18. Chen VK, Arguedas MR, Kilgore ML, Eloubeidi MA. A cost-minimization analysis of alternative strategies in diagnosing pancreatic cancer. Am J Gastroenterol. 2004;99(11):2223–34.

    Article  PubMed  Google Scholar 

  19. Erickson RA, Sayage-Rabie L, Beissner RS. Factors predicting the number of EUS-guided fine-needle passes for diagnosis of pancreatic malignancies. Gastrointest Endosc. 2000;51(2):184–90.

    Article  CAS  PubMed  Google Scholar 

  20. Moller K, Papanikolaou IS, Toermer T, Delicha EM, Sarbia M, Schenck U, et al. EUS-guided FNA of solid pancreatic masses: high yield of 2 passes with combined histologic-cytologic analysis. Gastrointest Endosc. 2009;70(1):60–9.

    Article  PubMed  Google Scholar 

  21. Collins BT, Murad FM, Wang JF, Bernadt CT. Rapid on-site evaluation for endoscopic ultrasound-guided fine-needle biopsy of the pancreas decreases the incidence of repeat biopsy procedures. Cancer Cytopathol. 2013;121(9):518–24.

    Article  PubMed  Google Scholar 

  22. Layfield LJ, Bentz JS, Gopez EV. Immediate on-site interpretation of fine-needle aspiration smears: a cost and compensation analysis. Cancer. 2001;93(5):319–22.

    Article  CAS  PubMed  Google Scholar 

  23. Aadam AA, Wani S, Amick A, Shah JN, Bhat YM, Hamerski CM, et al. A randomized controlled cross-over trial and cost analysis comparing endoscopic ultrasound fine needle aspiration and fine needle biopsy. Endosc Int Open. 2016;4(5):E497–505.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Kamata K, Kitano M, Yasukawa S, Kudo M, Chiba Y, Ogura T, et al. Histologic diagnosis of pancreatic masses using 25-gauge endoscopic ultrasound needles with and without a core trap: a multicenter randomized trial. Endoscopy. 2016;48(7):632–8.

    Article  PubMed  Google Scholar 

  25. Bang JY, Hawes R, Varadarajulu S. A meta-analysis comparing ProCore and standard fine-needle aspiration needles for endoscopic ultrasound-guided tissue acquisition. Endoscopy. 2016;48(4):339–49.

    PubMed  Google Scholar 

  26. Levy MJ. Endoscopic ultrasound-guided trucut biopsy of the pancreas: prospects and problems. Pancreatology. 2007;7(2–3):163–6.

    Article  PubMed  Google Scholar 

  27. Aithal GP, Anagnostopoulos GK, Tam W, Dean J, Zaitoun A, Kocjan G, et al. EUS-guided tissue sampling: comparison of “dual sampling” (Trucut biopsy plus FNA) with “sequential sampling” (Trucut biopsy and then FNA as required). Endoscopy. 2007;39(8):725–30.

    Article  CAS  PubMed  Google Scholar 

  28. Mizuno N, Bhatia V, Hosoda W, Sawaki A, Hoki N, Hara K, et al. Histological diagnosis of autoimmune pancreatitis using EUS-guided trucut biopsy: a comparison study with EUS-FNA. J Gastroenterol. 2009;44(7):742–50.

    Article  CAS  PubMed  Google Scholar 

  29. Shah SM, Ribeiro A, Levi J, Jorda M, Rocha-Lima C, Sleeman D, et al. EUS-guided fine needle aspiration with and without trucut biopsy of pancreatic masses. JOP. 2008;9(4):422–30.

    PubMed  Google Scholar 

  30. Varadarajulu S, Bang JY, Hebert-Magee S. Assessment of the technical performance of the flexible 19-gauge EUS-FNA needle. Gastrointest Endosc. 2012;76(2):336–43.

    Article  PubMed  Google Scholar 

  31. Eloubeidi MA, Tamhane A, Varadarajulu S, Wilcox CM. Frequency of major complications after EUS-guided FNA of solid pancreatic masses: a prospective evaluation. Gastrointest Endosc. 2006;63(4):622–9.

    Article  PubMed  Google Scholar 

  32. Bournet B, Migueres I, Delacroix M, Vigouroux D, Bornet JL, Escourrou J, et al. Early morbidity of endoscopic ultrasound: 13 year’s experience at a referral center. Endoscopy. 2006;38(4):349–54.

    Article  CAS  PubMed  Google Scholar 

  33. Eloubeidi MA, Gress FG, Savides TJ, Wiersema MJ, Kochman ML, Ahmad NA, et al. Acute pancreatitis after EUS-guided FNA of solid pancreatic masses: a pooled analysis from EUS centers in the United States. Gastrointest Endosc. 2004;60(3):385–9.

    Article  PubMed  Google Scholar 

  34. Jenssen C, Alvarez-Sanchez MV, Napoleon B, Faiss S. Diagnostic endoscopic ultrasonography: assessment of safety and prevention of complications. World J Gastroenterol. 2012;18(34):4659–76.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Ahmed K, Sussman JJ, Wang J, Schmulewitz N. A case of EUS-guided FNA-related pancreatic cancer metastasis to the stomach. Gastrointest Endosc. 2011;74(1):231–3.

    Article  PubMed  Google Scholar 

  36. Paquin SC, Gariepy G, Lepanto L, Bourdages R, Raymond G, Sahai AV. A first report of tumor seeding because of EUS-guided FNA of a pancreatic adenocarcinoma. Gastrointest Endosc. 2005;61(4):610–1.

    Article  PubMed  Google Scholar 

  37. Ngamruengphong S, Swanson KM, Shah ND, Wallace MB. Preoperative endoscopic ultrasound-guided fine needle aspiration does not impair survival of patients with resected pancreatic cancer. Gut. 2015;64(7):1105–10.

    Article  PubMed  Google Scholar 

  38. Brais RJ, Davies SE, O'Donovan M, Simpson BW, Cook N, Darbonne WC, et al. Direct histological processing of EUS biopsies enables rapid molecular biomarker analysis for interventional pancreatic cancer trials. Pancreatology. 2012;12(1):8–15.

    Article  CAS  PubMed  Google Scholar 

  39. Tada M, Komatsu Y, Kawabe T, Sasahira N, Isayama H, Toda N, et al. Quantitative analysis of K-ras gene mutation in pancreatic tissue obtained by endoscopic ultrasonography-guided fine needle aspiration: clinical utility for diagnosis of pancreatic tumor. Am J Gastroenterol. 2002;97(9):2263–70.

    Article  CAS  PubMed  Google Scholar 

  40. Vila-Navarro E, Vila-Casadesus M, Moreira L, Duran-Sanchon S, Sinha R, Gines A, et al. Micro RNAs for detection of pancreatic neoplasia: biomarker discovery by next-generation sequencing and validation in 2 independent cohorts. Ann Surg. 2016;8:1048.

    Google Scholar 

  41. Frampton AE, Krell J, Mato Prado M, Gall TM, Abbassi-Ghadi N, Del Vecchio Blanco G, et al. Prospective validation of microRNA signatures for detecting pancreatic malignant transformation in endoscopic-ultrasound guided fine-needle aspiration biopsies. Oncotarget. 2016;7:28556.

    PubMed  PubMed Central  Google Scholar 

  42. Gleeson FC, Kerr SE, Kipp BR, Voss JS, Minot DM, Tu ZJ, et al. Targeted next generation sequencing of endoscopic ultrasound acquired cytology from ampullary and pancreatic adenocarcinoma has the potential to aid patient stratification for optimal therapy selection. Oncotarget. 2016;7:54526.

    PubMed  PubMed Central  Google Scholar 

  43. Committee ASoP, Muthusamy VR, Chandrasekhara V, Acosta RD, Bruining DH, Chathadi KV, et al. The role of endoscopy in the diagnosis and treatment of cystic pancreatic neoplasms. Gastrointest Endosc. 2016;84(1):1–9.

    Article  Google Scholar 

  44. Brugge WR, Lewandrowski K, Lee-Lewandrowski E, Centeno BA, Szydlo T, Regan S, et al. Diagnosis of pancreatic cystic neoplasms: a report of the cooperative pancreatic cyst study. Gastroenterology. 2004;126(5):1330–6.

    Article  PubMed  Google Scholar 

  45. Kim KW, Park SH, Pyo J, Yoon SH, Byun JH, Lee MG, et al. Imaging features to distinguish malignant and benign branch-duct type intraductal papillary mucinous neoplasms of the pancreas: a meta-analysis. Ann Surg. 2014;259(1):72–81.

    Article  PubMed  Google Scholar 

  46. van der Waaij LA, van Dullemen HM, Porte RJ. Cyst fluid analysis in the differential diagnosis of pancreatic cystic lesions: a pooled analysis. Gastrointest Endosc. 2005;62(3):383–9.

    Article  PubMed  Google Scholar 

  47. Crippa S, Bassi C, Salvia R, Malleo G, Marchegiani G, Rebours V, et al. Low progression of intraductal papillary mucinous neoplasms with worrisome features and high-risk stigmata undergoing non-operative management: a mid-term follow-up analysis. Gut. 2017;66(3):495–506.

    Google Scholar 

  48. Del Chiaro M, Verbeke C, Salvia R, Kloppel G, Werner J, McKay C, et al. European experts consensus statement on cystic tumours of the pancreas. Dig Liver Dis. 2013;45(9):703–11.

    Article  PubMed  Google Scholar 

  49. Springer S, Wang Y, Dal Molin M, Masica DL, Jiao Y, Kinde I, et al. A combination of molecular markers and clinical features improve the classification of pancreatic cysts. Gastroenterology. 2015;149(6):1501–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Jais B, Rebours V, Malleo G, Salvia R, Fontana M, Maggino L, et al. Serous cystic neoplasm of the pancreas: a multinational study of 2,622 patients under the auspices of the international association of pancreatology and European pancreatic club (European Study Group on Cystic Tumors of the Pancreas). Gut. 2016;65(2):305–12.

    Article  CAS  PubMed  Google Scholar 

  51. Konda VJ, Meining A, Jamil LH, Giovannini M, Hwang JH, Wallace MB, et al. A pilot study of in vivo identification of pancreatic cystic neoplasms with needle-based confocal laser endomicroscopy under endosonographic guidance. Endoscopy. 2013;45(12):1006–13.

    Article  PubMed  Google Scholar 

  52. Napoleon B, Lemaistre AI, Pujol B, Caillol F, Lucidarme D, Bourdariat R, et al. A novel approach to the diagnosis of pancreatic serous cystadenoma: needle-based confocal laser endomicroscopy. Endoscopy. 2015;47(1):26–32.

    PubMed  Google Scholar 

  53. Canto MI, Harinck F, Hruban RH, Offerhaus GJ, Poley JW, Kamel I, et al. International cancer of the pancreas screening (CAPS) Consortium summit on the management of patients with increased risk for familial pancreatic cancer. Gut. 2013;62(3):339–47.

    Article  PubMed  Google Scholar 

  54. Langer P, Kann PH, Fendrich V, Habbe N, Schneider M, Sina M, et al. Five years of prospective screening of high-risk individuals from families with familial pancreatic cancer. Gut. 2009;58(10):1410–8.

    Article  CAS  PubMed  Google Scholar 

  55. Bartsch DK, Gress TM, Langer P. Familial pancreatic cancer – current knowledge. Nat Rev Gastroenterol Hepatol. 2012;9(8):445–53.

    Article  CAS  PubMed  Google Scholar 

  56. Bartsch DK, Slater EP, Carrato A, Ibrahim IS, Guillen-Ponce C, Vasen HF, et al. Refinement of screening for familial pancreatic cancer. Gut. 2016;65:1314.

    Article  CAS  PubMed  Google Scholar 

  57. Vasen H, Ibrahim I, Ponce CG, Slater EP, Matthai E, Carrato A, et al. Benefit of surveillance for pancreatic cancer in high-risk individuals: outcome of long-term prospective follow-up studies from three European expert centers. J Clin Oncol. 2016;34(17):2010–9.

    Article  CAS  PubMed  Google Scholar 

  58. Levy MJ, Wiersema MJ. Endoscopic ultrasound-guided pain control for intra-abdominal cancer. Gastroenterol Clin N Am. 2006; 35(1):153–65, x.

    Google Scholar 

  59. Gress F, Schmitt C, Sherman S, Ikenberry S, Lehman G. A prospective randomized comparison of endoscopic ultrasound- and computed tomography-guided celiac plexus block for managing chronic pancreatitis pain. Am J Gastroenterol. 1999;94(4):900–5.

    Article  CAS  PubMed  Google Scholar 

  60. Wyse JM, Carone M, Paquin SC, Usatii M, Sahai AV. Randomized, double-blind, controlled trial of early endoscopic ultrasound-guided celiac plexus neurolysis to prevent pain progression in patients with newly diagnosed, painful, inoperable pancreatic cancer. J Clin Oncol. 2011;29(26):3541–6.

    Article  PubMed  Google Scholar 

  61. Fujii L, Clain JE, Morris JM, Levy MJ. Anterior spinal cord infarction with permanent paralysis following endoscopic ultrasound celiac plexus neurolysis. Endoscopy. 2012;44(Suppl 2 UCTN):E265–6.

    PubMed  Google Scholar 

  62. Loeve US, Mortensen MB. Lethal necrosis and perforation of the stomach and the aorta after multiple EUS-guided celiac plexus neurolysis procedures in a patient with chronic pancreatitis. Gastrointest Endosc. 2013;77(1):151–2.

    Article  PubMed  Google Scholar 

  63. Jang HY, Cha SW, Lee BH, Jung HE, Choo JW, Cho YJ, et al. Hepatic and splenic infarction and bowel ischemia following endoscopic ultrasound-guided celiac plexus neurolysis. Clin Endosc. 2013;46(3):306–9.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Park WG, Yan BM, Schellenberg D, Kim J, Chang DT, Koong A, et al. EUS-guided gold fiducial insertion for image-guided radiation therapy of pancreatic. Cancer: 50 successful cases without fluoroscopy. Gastrointest Endosc. 2010;71(3):513–8.

    Article  PubMed  Google Scholar 

  65. Luz LP, Al-Haddad MA, Sey MS, DeWitt JM. Applications of endoscopic ultrasound in pancreatic cancer. World J Gastroenterol. 2014;20(24):7808–18.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Jin Z, Du Y, Li Z, Jiang Y, Chen J, Liu Y. Endoscopic ultrasonography-guided interstitial implantation of iodine 125-seeds combined with chemotherapy in the treatment of unresectable pancreatic carcinoma: a prospective pilot study. Endoscopy. 2008;40(4):314–20.

    Article  CAS  PubMed  Google Scholar 

  67. Du Y, Jin Z, Jin H, Meng H, Zou D, Chen J, et al. Long-term effect of gemcitabine-combined endoscopic ultrasonography-guided brachytherapy in pancreatic cancer. J Interv Gastroenterol. 2013;3(1):18–24.

    Article  Google Scholar 

  68. Chang KJ, Nguyen PT, Thompson JA, Kurosaki TT, Casey LR, Leung EC, et al. Phase I clinical trial of allogeneic mixed lymphocyte culture (cytoimplant) delivered by endoscopic ultrasound-guided fine-needle injection in patients with advanced pancreatic carcinoma. Cancer. 2000;88(6):1325–35.

    Article  CAS  PubMed  Google Scholar 

  69. Hirooka Y, Itoh A, Kawashima H, Hara K, Nonogaki K, Kasugai T, et al. A combination therapy of gemcitabine with immunotherapy for patients with inoperable locally advanced pancreatic cancer. Pancreas. 2009;38(3):e69–74.

    Article  CAS  PubMed  Google Scholar 

  70. Herman JM, Wild AT, Wang H, Tran PT, Chang KJ, Taylor GE, et al. Randomized phase III multi-institutional study of TNFerade biologic with fluorouracil and radiotherapy for locally advanced pancreatic cancer: final results. J Clin Oncol. 2013;31(7):886–94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  71. Khashab MA, Dewitt J. EUS-guided biliary drainage: is it ready for prime time? Yes! Gastrointest Endosc. 2013;78(1):102–5.

    Article  PubMed  Google Scholar 

  72. Park do H, Jeong SU, Lee BU, Lee SS, Seo DW, Lee SK, et al. Prospective evaluation of a treatment algorithm with enhanced guidewire manipulation protocol for EUS-guided biliary drainage after failed ERCP (with video). Gastrointest Endosc. 2013;78(1):91–101.

    Google Scholar 

  73. Itoi T, Ishii K, Tanaka R, Umeda J, Tonozuka R. Current status and perspective of endoscopic ultrasonography-guided gastrojejunostomy: endoscopic ultrasonography-guided double-balloon-occluded gastrojejunostomy (with videos). J Hepatobiliary Pancreat Sci. 2015;22(1):3–11.

    Article  PubMed  Google Scholar 

  74. Khashab MA, Kumbhari V, Grimm IS, Ngamruengphong S, Aguila G, El Zein M, et al. EUS-guided gastroenterostomy: the first U.S. clinical experience (with video). Gastrointest Endosc. 2015;82(5):932–8.

    Article  PubMed  Google Scholar 

  75. DeWitt J, McGreevy K, Schmidt CM, Brugge WR. EUS-guided ethanol versus saline solution lavage for pancreatic cysts: a randomized, double-blind study. Gastrointest Endosc. 2009;70(4):710–23.

    Article  PubMed  Google Scholar 

  76. Oh HC, Seo DW, Song TJ, Moon SH, Park DH, Soo Lee S, et al. Endoscopic ultrasonography-guided ethanol lavage with paclitaxel injection treats patients with pancreatic cysts. Gastroenterology. 2011;140(1):172–9.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Gastroenterology, Endocrinology, Metabolism and Infectiology, Philipps University Marburg, Baldinger Strasse, 35043, Marburg, Germany

    Tobias Grote & Thomas Mathias Gress

Authors
  1. Tobias Grote
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Thomas Mathias Gress
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Thomas Mathias Gress .

Editor information

Editors and Affiliations

  1. Div. Surgery & Oncology, University of Liverpool, Liverpool, United Kingdom

    John P. Neoptolemos

  2. Rochester, Minnesota, USA

    Raul Urrutia

  3. Dept. Gastrointestinal Medical Onco, Duke University Medical Center Dept. Gastrointestinal Medical Onco, Durham, North Carolina, USA

    James Abbruzzese

  4. Heidelberg, Germany

    Markus W. Büchler

Section Editor information

  1. Duke University Medical Center, Durham, NC, USA

    James L. Abbruzzese

  2. Mayo Clinic Cancer Center, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA

    Raul A. Urrutia

  3. Division of Surgery and Oncology, University of Liverpool, Daulby Street, Liverpool, UK

    John Neoptolemos

  4. Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany

    Markus W. Büchler MD

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer Science+Business Media LLC

About this entry

Cite this entry

Grote, T., Gress, T.M. (2016). EUS and Its Role in Pancreatic Cancer. In: Neoptolemos, J., Urrutia, R., Abbruzzese, J., Büchler, M. (eds) Pancreatic Cancer. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-6631-8_79-1

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-6631-8_79-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-6631-8

  • Online ISBN: 978-1-4939-6631-8

  • eBook Packages: Springer Reference Biomedicine and Life SciencesReference Module Biomedical and Life Sciences

Publish with us

Policies and ethics

Search

Navigation