Digestive endoscopy is undergoing a period of great expansion and technological innovation, featuring advances particularly in the surgical and therapeutic fields which challenge the traditional techniques of diagnostic endoscopy.

The symposium had a large audience and 18 procedures were performed on the same number of patients, the session's highlights. Echoendoscopy, endoscopic mucosectomy, colonoscopy and endoscopic retrograde cholangiopancreatography (ERCP) were some of the techniques used and explained in real time by gastroenterologists in the OR, delivered to a very attentive audience.

Screening pancreatic cancer

Another highlight was the talk on the possibilities of screening pancreatic cancer, an extremely aggressive form of cancer, the survival rate being 5% at the end of five years and where each case practically equals death.

According to Júlio Iglesias Garcia, MD at the Department of Gastroenterology, Santiago de Compostela University Hospital, this has to do with late diagnosis, when 80-85% of the pancreatic lesions are inoperable.

In face of such a tragic scenario, Júlio Iglesias Garcia asked whether it was not worthwhile investing in early diagnosis. Consequently, he found that a patient's prognosis clearly improves when the lesions are detected during the premalignant stage, almost in the same way as with colorectal cancer. “In cancer of the pancreas, we know we are screening for premalignant lesions or small-sized cancers when we discover lesions under 2 cm”.

As for the diagnostic methods, this expert found that MRI or ultrasound endoscopy, either individually or combined, are the safest ways of detecting small lesions.

As for the target groups for screening, Júlio Iglesias Garcia indicated the age group of 45 years and more, family history and the existence of specific genetic mutations as the main risk factors that must be taken into account in the early diagnosis of pancreatic cancer.

He underlined further that the screening must target precursor lesions, whose monitoring is possibly the most difficult aspect of patient management.