Interventional endoscopic ultrasonography

Abstract

Endoscopic ultrasonography (EUS) is the combination of endoscopy and intraluminal ultrasonography. This allows use of a high frequency transducer, which, due to the short distance to the target lesion, enables ultrasonographic images of high resolution to be obtained. Endoscopic ultrasonography is now a widely accepted modality for the diagnosis of pancreatobiliary diseases. It can be used to determine the depth of invasion of gastrointestinal malignancies, and often for visualizing lesions more precisely than other imaging modalities. The most important early limitation of EUS was the lack of specificity in the differentiation between benign and malignant changes. In 1992, EUS-guided fine needle aspiration (EUS-FNA) of lesions in the pancreas head has been made possible using a curved linear array echoendoscope. Since then, many researchers have expanded the indication of EUS-FNA to various kinds of lesions and also for a variety of therapeutic purposes. In this review, we particularly focus on the present and future roles of interventional EUS, including EUS-FNA and therapeutic EUS.

Endorectal Ultrasound-Guided Fine-Needle Aspiration: A Useful Diagnostic Tool for Perirectal and Intraluminal Lesions

“…In Japan, the current indications for EUS-FNA include: differentiating between benign and malignant lesions, staging of cancer, and to establish the endoscopic diagnosis of malignancy before chemotherapy and/or radiation therapy [15]. Perirectal lymph nodes or masses, submucosal masses, and suspected recurrent cancers in and adjacent to surgical anastomoses are potential targets for ERUS-FNA.…”

Minimally Invasive Management of Lesser Sac Bronchogenic Cyst

“…22,23 Endoscopic fine needle aspiration secured a diagnosis of a bronchogenic cyst in our case. Furthermore, the absence of 2 muscle layers offered us assurance that the patient did not have an esophageal duplication cyst that might have required a more elaborate, and perhaps open, operation.…”

The palliation of cholangiocarcinoma

“…In those patients in whom cannulation of the papilla during ERCP has failed and dilated intrahepatic ducts are present, a puncture can be made via the stomach into the left hepatic duct using EUS guidance [30][31][32]33 & ]. A wire can then be passed through the tract into the biliary system and out through the major papilla.…”