Learning in therapeutic EUS

Giovannini, Marc

doi:10.4103/eus-d-21-00205

Cited by 7 publications

(5 citation statements)

References 16 publications

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“…The trainees should have high success rate of EUS tissue acquisition (>90%) and ability to puncture a 5 mm lesion before commencing PFC drainage. 97 Another concept is that knowledge of X-ray and guidewire manipulation 96 is helpful, although this is not needed when the LAMS are used and ERCP skills are beneficial, but not essential to the endoscopist learning EUS-guided drainage. 21 The skills in EUS-guided PFC drainage are best acquired through observation, followed by hands-on training in the porcine model and execution of the procedure in patients.…”

Section: Postprocedural Approachmentioning

confidence: 99%

Endoscopic ultrasound drainage of pancreatic fluid collections: do we know enough about the best approach?

Seicean

Pojoga

Rednic

et al. 2023

Therap Adv Gastroenterol

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Pancreatic fluid collection often occurs as a local complication of acute pancreatitis, and drainage is indicated in symptomatic patients. The drainage may be surgical, percutaneous, or endoscopic ultrasound (EUS) guided. In symptomatic collections older than 4 weeks and localized in the upper abdomen, EUS-guided drainage is the first choice of treatment. Lumen-apposing metal stents are useful in cases of walled-off necrosis, facilitating access to the cavity; however, they do not reduce the number of necrosectomy sessions required. In most pancreatic pseudocysts requiring drainage, plastic stents remain the first choice of treatment. This review aimed to summarize the principles and techniques of step-up therapy of pancreatic fluid collections, including preprocedural and postprocedural assessment and practical approaches of drainage and necrosectomy, making available evidence more accessible to endoscopists aiming to train for this procedure. Successful and safe EUS drainage connotes early recognition and treatment of complications and the presence of a multidisciplinary team for optimal patient management. However, the best time for necrosectomy, modality of drainage method (lumen-apposing metal stents or plastic stents), and duration of antibiotherapy are still under evaluation.

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Section: Postprocedural Approachmentioning

confidence: 99%

Endoscopic ultrasound drainage of pancreatic fluid collections: do we know enough about the best approach?

Seicean

Pojoga

Rednic

et al. 2023

Therap Adv Gastroenterol

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“…To achieve a systematic approach, it is crucial to understand the general differences of simulation-based settings [ Figure 1 ]. Basically, there are two distinct simulation tools: Part-task trainers such as phantoms and animal models,[ 9 ] and full-task trainer such as virtual ultrasound simulators. A phantom is examined with an actual ultrasound device and probe.…”

Section: Overview Of Simulation Tools and Technical Aspectsmentioning

confidence: 99%

The ultrasound use of simulators, current view, and perspectives: Requirements and technical aspects (WFUMB state of the art paper)

Dietrich

Lucius²,

Nielsen³

et al. 2022

Endoscopic Ultrasound

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Simulation has been shown to improve clinical learning outcomes, speed up the learning process and improve learner confidence, whilst initially taking pressure off busy clinical lists. The World Federation for Ultrasound in Medicine and Biology (WFUMB) state of the art paper on the use of simulators in ultrasound education introduces ultrasound simulation, its advantages and challenges. It describes different simulator types, including low and high-fidelity simulators, the requirements and technical aspects of simulators, followed by the clinical applications of ultrasound simulation. The paper discusses the role of ultrasound simulation in ultrasound clinical training, referencing established literature. Requirements for successful ultrasound simulation acceptance into educational structures are explored. Despite being in its infancy, ultrasound simulation already offers a wide range of training opportunities and likely holds the key to a broader point of care ultrasound education for medical students, practicing doctors, and other health care professionals. Despite the drawbacks of simulation, there are also many advantages, which are expanding rapidly as the technology evolves.

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“…EUS-guided interventional therapy is the main treatment method for many diseases including drainage of the bile duct, gallbladder, peripancreatic fluid collections, or even the gastrointestinal tract through gastroenterostomy. [ 1 2 3 4 ] In particular, EUS-guided gallbladder drainage (EUS-GBD) is increasingly becoming the recommended treatment for patients with high-risk acute cholecystitis. [ 5 6 ] However, with the development of this treatment, gallbladder collapse due to bile leakage during the puncture process has become the main technical issue against surgical success, with bile leakage possibly causing adverse events such as acute peritonitis.…”

Section: Introductionmentioning

confidence: 99%

Ex vivo comparison of electrocautery-enhanced delivery of lumen-apposing metal stents matching electrosurgical workstations during EUS-guided gallbladder drainage

Zhang

Guo

et al. 2022

Endoscopic Ultrasound

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Background and Objectives: EUS-guided gallbladder drainage (EUS-GBD) has become one of the recommended treatments for patients with high-risk acute cholecystitis. However, the gallbladder reportedly collapsed due to bile leakage, which was a disadvantage that affects the surgical success rate. Different electrocautery-enhanced delivery of the lumen-apposing metal stents (ECE-LAMSs) using suitable power levels in electrosurgical workstations can increase the surgical success rate and reduce trauma. Therefore, we proposed the use of the ECE-LAMSs and electrosurgical workstations for the first time through ex vivo experiments to adjust the different power levels and select the most suitable electrosurgical power for each ECE-LAMS type. Methods: We compared three types of ECE-LAMS (9Fr, 10.5Fr, and 10.8Fr) with three types of electrosurgical workstations during EUS-GBD. GBD was simulated ex vivo under the guidance of an ultrasound endoscope. We performed various power tests to elucidate the ideal electric power for different ECE-LAMS combined with the different types of electrosurgical workstations. Results: For the 10.8Fr ECE-LAMS matched with the Martin, Erbe, and Olympus electrosurgical workstations, the ideal power levels were 200 W, 200 W, and 250W. For the 10.5Fr and 9Fr ECE-LAMS matched with the Martin, Erbe, and Olympus electrosurgical workstations, the ideal power levels were 150 W, 200 W, and 200 W. Conclusion: During the operations, due to low-power levels in the electrosurgical workstations increased the number of cuts, the EUS images were obviously unclear, which affected the success rates of the operations. We suggested different power levels for the different types of LAMS and their matching electrosurgical workstations, which can increase the surgical success rates and reduce surgical injuries.

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Learning in therapeutic EUS

Cited by 7 publications

References 16 publications

Endoscopic ultrasound drainage of pancreatic fluid collections: do we know enough about the best approach?

Endoscopic ultrasound drainage of pancreatic fluid collections: do we know enough about the best approach?

The ultrasound use of simulators, current view, and perspectives: Requirements and technical aspects (WFUMB state of the art paper)

Ex vivo comparison of electrocautery-enhanced delivery of lumen-apposing metal stents matching electrosurgical workstations during EUS-guided gallbladder drainage

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