Endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) are the mainstays of interventional endoscopic practice. EUS occupies a central role in the diagnosis of pancreatobiliary neoplasms and offers a platform for a wide range of direct tumor therapies. Initial steps have demonstrated the feasibility of such applications in animal models and pilot studies. Larger clinical trials and incorporation of EUS-based therapies into cooperative cancer studies might demonstrate an impact in the clinical prognosis of patients with pancreatic cancer. ERCP plays an important role in elucidating indeterminate biliary strictures and in treating patients with malignant biliary obstruction who are symptomatic or have borderline-resectable or unresectable disease. ERCP-directed ablative therapies enable neoadjuvant and palliative intervention in patients with malignant biliary obstruction, in particular perihilar cholangiocarcinoma. Additional comparative, multicenter studies are needed to better understand the safety and efficacy of endobiliary brachytherapy, photodynamic therapy, and radiofrequency ablation in patients with pancreatobiliary malignancies.

内镜超声（EUS）和内镜逆行胰胆管造影术（ERCP）是介入内镜实践的主要手段。EUS在胰腺胆道肿瘤的诊断中起着核心作用，并为广泛的直接肿瘤治疗提供了平台。初步步骤已经证明了在动物模型和中试研究中应用此类方法的可行性。更大的临床试验以及将基于EUS的疗法纳入合作性癌症研究中可能表明对胰腺癌患者的临床预后有影响。ERCP在阐明不确定的胆道狭窄以及治疗有症状或可边缘切除或不可切除的恶性胆道梗阻患者中起着重要作用。ERCP指导的消融治疗可对恶性胆道梗阻（尤其是肝门周围胆管癌）患者进行新辅助和姑息治疗。需要更多的比较性，多中心研究来更好地了解胰胆管恶性肿瘤患者的胆道近距离放射治疗，光动力疗法和射频消融的安全性和有效性。