What are the current and potential future roles for endoscopic ultrasound in the treatment of pancreatic cancer?

Figure 2 A 84 years old male with duodenal adenocarcinoma causing biliary obstruction underwent endoscopic ultrasound-guided choledochoduodenostomy following unsuccessful endoscopic retrograde cholangiopancreatography. A: Tumor involving the major papilla; B: Endoscopic ultrasound-guided puncture of the common bile duct through the duodenum with a 19-gauge needle; C: Guidewire insertion and balloon dilation of a choledochoduodenal fistula; D: Followed by the placement of a 10 mm × 10 mm lumen-apposing metal stent to create a choledochoduodenostomy; E and F: Endoscopic (E) and flouroscopic (F) view after the placement of a 7 Fr × 3 cm double pigtail stent into the common hepatic duct.