The emerging role of endoscopic ultrasound for pancreaticobiliary diseases in the pediatric population

Patel, Suril; Marshak, Jarred; Daum, Fredric; Iqbal, Shahzad

doi:10.1007/s12519-017-0020-y

Cited by 14 publications

(8 citation statements)

References 60 publications

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“…Larissa Latrilha GARCIA 1 , Eloy TAGLIERI 1 , Otávio MICELLI-NETO 1 and José Celso ARDENGH 1,2,3 pediatric use, there has been a surge in studies in this population (9)(10)(11)(12) . D-EUS and I-EUS are performed by gastroenterologists who have conducted these procedures in adults (6,13) .…”

Section: Impact Of Diagnostic and Interventional Endoscopic Ultrasono...mentioning

confidence: 99%

Impact of Diagnostic and Interventional Endoscopic Ultrasonography in Children

Garcia

Taglieri

Micelli-Neto

et al. 2022

Arq. Gastroenterol.

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Background: Endoscopic ultrasonography is used in the diagnosis and treatment of digestive diseases in adults. In children, its use is limited due to a lack of available expertise. Objective: This study aimed to evaluate the clinical impact of endoscopic ultrasonography on diagnostic and therapeutic strategy changes in pediatric patients. Methods: Over ten years, this study retrospectively and consecutively analyzed children aged ≤18 years who underwent endoscopic ultrasonography because of inconclusive imaging or laboratory tests. The indications, results, occurrence of adverse events, and clinical impact of the procedures were analyzed. The clinical impact was classified as major (when the findings led to changes in diagnosis and management), minor (change in diagnosis but not in management), or none (no change in diagnosis or management). Results: Overall, 107 children [77 (72%) of whom were female; mean age: 11.7 ± 4 years] underwent upper [102 (95.3%)] and lower [5 (4.7%)] endoscopic ultrasonography; 64 (58%) patients underwent diagnostic endoscopic ultrasonography, and 43 (42%) underwent interventional endoscopic ultrasonography. Endoscopic ultrasonography was used to investigate pancreaticobiliary, gastric, rectal, esophageal, duodenal, and mediastinal diseases in 81 (76%), 14 (13%), 5 (4.6%), 3 (2.8%), 2 (1.8%), and 2 (1.8%) patients, respectively. The clinical impact was significant in 81% of the children. Major and no clinical impact on pancreaticobiliary, gastrointestinal diseases, and mediastinal masses occurred in 50 (62%) and 13 (16%), 13 (54%) and 9 (37%), and 2 (100%) and 0 (0%) of the patients, respectively. Conclusion: This study evaluated the impact of diagnostic and interventional endoscopic ultrasonography in pediatric patients. When clinically and appropriately indicated, these procedures are safe and effective diagnostic or therapeutic interventions in pediatric patients with gastrointestinal or pancreaticobiliary disorders.

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Section: Impact Of Diagnostic and Interventional Endoscopic Ultrasono...mentioning

confidence: 99%

Impact of Diagnostic and Interventional Endoscopic Ultrasonography in Children

Garcia

Taglieri

Micelli-Neto

et al. 2022

Arq. Gastroenterol.

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“…Although the literature reports that the application of linear echo-endoscopes may be feasible in patients weighing at least 15–25 kg, available data regarding this modality remain limited. 7 Moreover, to date, most studies have focused on the diagnostic role of EUS in pediatrics, 4 , 8 , 9 while studies evaluating its therapeutic role are fewer in number. 10 , 11 …”

Section: Introductionmentioning

confidence: 99%

“…3 In children, the most frequent indication of EUS is evaluation of the pancreaticobiliary tract, especially for common bile duct (CBD) pathology, evaluation of acute or chronic pancreatitis, and pancreaticobiliary anomalies. 4 Furthermore, EUS is an appropriate tool to differentiate the GI wall Safety and efficacy of endoscopic ultrasound as a diagnostic and therapeutic tool in pediatric patients: a multicenter study 2 journals.sagepub.com/home/cmg…”

Section: Introductionmentioning

confidence: 99%

“…6 Although the literature reports that the application of linear echo-endoscopes may be feasible in patients weighing at least 15-25 kg, available data regarding this modality remain limited. 7 Moreover, to date, most studies have focused on the diagnostic role of EUS in pediatrics, 4,8,9 while studies evaluating its therapeutic role are fewer in number. 10,11 The indication for EUS in this age group is expanding; thus, there is an unmet need to assess the safety and efficacy of EUS as a diagnostic and therapeutic modality in pediatric patients.…”

Section: Introductionmentioning

confidence: 99%

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Safety and efficacy of endoscopic ultrasound as a diagnostic and therapeutic tool in pediatric patients: a multicenter study

Ragab

Kassas

Madkour

et al. 2022

Clin Med Insights Gastroenterol

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Background: Despite the well-established diagnostic and therapeutic applications of endoscopic ultrasound (EUS) in adults, data about its use in children are limited. In this study, we tried to assess the feasibility, safety, and clinical impact of EUS in pediatric patients. Methods: Data of pediatric patients (<18 years) referred for EUS over a 3-year period to the endoscopy units of four Egyptian tertiary centers were retrospectively analyzed. Significant impact was defined as a new diagnosis or treatment attributed to the EUS procedure. Results: Twenty-four diagnostic and five therapeutic EUS procedures were conducted in 29 children with a median age of 9 years. Indications for EUS included assessment of solid pancreatic mass ( n = 3), pancreatic cyst ( n = 2), suspected chronic pancreatitis ( n = 9), pancreatic pseudocyst (PPC) ( n = 5), recurrent hypoglycemia ( n = 1), bile duct mass ( n = 1), subepithelial lesion (esophageal, duodenal or anorectal) ( n = 4), mediastinal mass ( n = 1), pelvic mass ( n = 3), and mass at splenic hilum ( n = 1). Therapeutically, five patients underwent cystogastrostomy for symptomatic PPC with 100% technical and clinical success. EUS was able to diagnose 21 out of the other 24 patients. EUS-guided tissue acquisition was performed in 11 patients with definitive histopathological diagnosis in 10 patients (91%). There was no procedure-related major complication, while minor complications occurred in two cases (transient pain in one case, temporary fever, and vomiting in two cases). Conclusion: Standard linear EUS equipment and accessories can be used safely and effectively in selected pediatric patients for diagnostic and therapeutic purposes.

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“…[ 2 3 ] Emerging data suggest the utility of EUS as a diagnostic as well as therapeutic modality in pediatric cases. [ 4 5 6 7 8 ] However, the current literature on EUS in children is sparse and remains limited to noninvasive pure diagnostic applications, especially in pancreato-biliary diseases, e.g. , recurrent pancreatitis or suspected biliary obstruction.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic utility of EUS-guided tissue acquisition in children: A tertiary care center experience

et al. 2021

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Background and Objectives: EUS is frequently utilized for tissue acquisition in adult patients. However, the literature is limited regarding the utility of EUS-guided fine-needle aspiration or biopsy (FNA or FNB) in children. In this study, we aim to evaluate the feasibility, safety, and diagnostic utility of EUS-FNA/FNB in children with various gastrointestinal diseases. Methods: The data of children (≤18 years) who underwent EUS-FNA/FNB from March 2014 to June 2020 were analyzed, retrospectively. The following parameters were analyzed: technical success, adverse events, and impact on the final diagnosis. Results: Sixty-seven children (32 – boys, 14.8 ± 2.9 years, range 8–18 years), underwent EUS-guided tissue acquisition procedures using standard therapeutic echoendoscope during the study period. The indications included solid pancreatic lesions in 29 (43.3%), mediastinal or abdominal lymphadenopathy in 30 (44.7%), cystic pancreatic lesions in 5 (7.5%), subepithelial lesions in 2 (3%), and retroperitoneal mass in 1 (1.5%). EUS-FNA and-FNB were performed in 42 and 25 children, respectively. All the procedures could be successfully performed and there was no major procedure-related adverse event. Minor adverse events included self-limiting throat pain (10) and abdominal pain (3), self-limited bleeding at puncture site (3), and transient fever (1). EUS-FNA/FNB provided a histopathological diagnosis in 59 (88.1%) children. Conclusion: EUS-guided tissue acquisition using standard echoendoscope is feasible and safe in the pediatric age group. EUS-FNA/FNB establishes diagnosis in majority of the children when performed for appropriate clinical indication.

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The emerging role of endoscopic ultrasound for pancreaticobiliary diseases in the pediatric population

Cited by 14 publications

References 60 publications

Impact of Diagnostic and Interventional Endoscopic Ultrasonography in Children

Impact of Diagnostic and Interventional Endoscopic Ultrasonography in Children

Safety and efficacy of endoscopic ultrasound as a diagnostic and therapeutic tool in pediatric patients: a multicenter study

Diagnostic utility of EUS-guided tissue acquisition in children: A tertiary care center experience

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