Ductal adenocarcinoma accounts for 90% of all pancreatic malignancies and is the fourth leading malignant cause of mortality in the Western world and the fifth in Russia. Comprehensive preoperative examination is aimed not only at making an accurate diagnosis, but also at determining treatment strategy. The diagnostic algorithm involves endoscopic ultrasound. The modern possibilities of endosonography combined with tissue contrast enhancement and fine-needle aspiration, as well as some aspects of palliative endoscopic treatment are analyzed in the article.

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The management of biliary decompression in malignant hilar carcinoma remains controversial. This review shows the most relevant aspects of endoprosthetics for proximal biliary obstruction, including necessity of stenting and morphological verification before radical surgery, selection of approach to drain etc. The main contradictions and ways to solve them are presented in this article, based on evidence researches, international and expert consensus conferences.

The preferred method in detection and staging of chronic radiation proctitis is colonoscopy. Moreover, endoscopy is used widely in treating patients with this disease. The main goal of endoscopic techniques is hemostasis and elimination of vascular transformations. This includes formalin application, band ligation, various types of laser irradiation, bipolar coagulation and cryotherapy. However, these methods are associated with relatively high risk of complications, whereas argon plasma coagulation and radiofrequency ablation are effective, relatively safe techniques for chronic radiation proctitis and well tolerated by patients.

Aim. To evaluate an effectiveness of endoscopic papillectomy (EA) for benign ampullary tumors.Material and methods. There were 45 patients with ampullary tumors who underwent endoscopic papillectomy in 2014–2018. Mean dimension of tumor was 2.25 ± 1.75 cm.Results. Papillectomy was successfully performed in all cases. En-bloc resection was completed in 24 cases (53%), while 21 (47%) patients had a piecemeal resection. Pancreatic duct stenting was carried out in 30 (67%) cases. Postoperative complication rate was 31%. Postoperative bleeding occurred in 8 (18%) cases, perforation in 4 (8.9%) cases, acute pancreatitis in 2 (4.4%) cases. Mortality was 4.4 % (n= 2). Local recurrence rate within 4-year period was 2.2% (n= 1). Mean length of hospital-stay was 13 days (13 ± 11) considering prolonged treatment of patients with complicated postoperative period.Conclusion. Endoscopic papillectomy is effective minimally invasive treatment of benign ampullary tumors. Regardless considerable morbidity rate, all of them may be effectively managed by medication or endoscopic procedure. EP can be considered as a first-line treatment of benign ampullary tumors.