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THERAPEUTIC EUS

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https://www.readbyqxmd.com/read/28315036/diagnosing-chronic-pancreatitis
#1
REVIEW
Ahmad Anaizi, Phil A Hart, Darwin L Conwell
Diagnosing CP can range from routine in those with severe disease and obvious calcifications on CT imaging to elusive in those patients with early changes in CP. The workup of suspected CP should follow a progressively noninvasive to more invasive STEP-wise approach in a patient with a suspicious clinical presentation and risk factors that raise their pretest probability of disease. After a thorough history and physical examination, basic laboratories should be obtained such as lipase, amylase, metabolic panel, and indirect PFTs (fecal elastase-1, serum trypsin)...
March 17, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28261439/therapeutic-endoscopic-ultrasound
#2
REVIEW
Suresh Venkatachalapathy, Manu K Nayar
Endoscopic ultrasound (EUS) is now firmly established as one of the essential tools for diagnosis in most gastrointestinal MDTs across the UK. However, the ability to provide therapy with EUS has resulted in a significant impact on the management of the patients. These include drainage of peripancreatic collections, EUS-guided endoscopic retrograde cholangiopancreatogram, EUS-guided coeliac plexus blocks, etc. The rapid development of this area in endoscopy is a combination of newer tools and increasing expertise by endosonographers to push the boundaries of intervention with EUS...
April 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28250896/endoscopy-guided-ablation-of-pancreatic-lesions-technical-possibilities-and-clinical-outlook
#3
REVIEW
Marianna Signoretti, Roberto Valente, Alessandro Repici, Gianfranco Delle Fave, Gabriele Capurso, Silvia Carrara
Endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP)-guided ablation procedures are emerging as a minimally invasive therapeutic alternative to radiological and surgical treatments for locally advanced pancreatic cancer (LAPC), pancreatic neuroendocrine tumours (PNETs), and pancreatic cystic lesions (PCLs). The advantages of treatment under endoscopic control are the real-time imaging guidance and the possibility to reach a deep target like the pancreas. Currently, radiofrequency probes specifically designed for ERCP or EUS ablation are available as well as hybrid cryotherm probe combining radiofrequency with cryotechnology...
February 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28230608/specialized-imaging-and-procedures-in-pediatric-pancreatology-a-north-american-society-for-pediatric-gastroenterology-hepatology-and-nutrition-clinical-report
#4
Tom K Lin, David M Troendle, Daniel B Wallihan, Bradley Barth, Victor L Fox, Douglas S Fishman, Veronique D Morinville
OBJECTIVES: An increasing number of children are being diagnosed with pancreatitis and other pancreatic abnormalities. Dissemination of the information regarding existing imaging techniques and endoscopic modalities to diagnose and manage pancreatic disorders in children is sorely needed. METHODS: We conducted a review of the medical literature on the use of the following imaging and procedural modalities in pediatric pancreatology: transabdominal ultrasonography (TUS), computed tomography (CT), magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasonography (EUS), and endoscopic retrograde cholangiopancreatography (ERCP)...
March 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28218199/contrast-harmonic-endoscopic-ultrasound-instrumentation-echoprocessors-and-echoendoscopes
#5
REVIEW
Julio Iglesias-Garcia, Jose Lariño-Noia, J Enrique Domínguez-Muñoz
Endoscopic ultrasound (EUS) has become as one the best diagnostic and therapeutic methods for the management of several intraintestinal and extraintestinal diseases, among them to highlight pancreaticobiliary indications, mediastinal evaluation, and the analysis of gastrointestinal lesions. Over the years, there has been an enormous evolution in the systems available to perform EUS. Newer processors and echoendoscopes are available nowadays, with the ability to perform new imaging analysis, such as elastography and contrast enhancement...
January 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28212155/molecular-markers-in-lung-cancer-role-of-ebus
#6
Semra Bilaçeroğlu
PURPOSE OF REVIEW: As demonstrated by the recent therapeutic advances in nonsmall cell lung cancer (NSCLC), a personalized approach can considerably reduce its mortality. RECENT FINDINGS: Molecular tests identifying genetic mutations in NSCLC have led to a shift towards more effective and personalized therapies targeted to these alterations. Adequate tissue is required for diagnosing, subcharacterizing, and genotyping NSCLC by morphological, immunohistochemical, and molecular techniques...
February 16, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28181708/interventional-eus-where-are-we-headed
#7
REVIEW
Marco J Bruno
EUS is an essential endoscopic tool within the diagnostic and therapeutic armamentarium of gastrointestinal and hepatic diseases. EUS-guided tissue acquisition will develop towards facilitating personalized treatment by obtaining large representative tissue specimens for elaborate immunohistochemical and biomolecular typing of the tumor. Intra-tumoral or intra-vascular delivery of drugs potentially offer many advantages over systemic injection. Intratumoral application of radiofrequency ablation and photodynamic therapy show promise but need to be explored further...
February 9, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28133274/-resection-of-a-huge-gastrointestinal-stromal-tumor-of-the-stomach-following-neoadjuvant-chemotherapy-with-imatinib
#8
Yoshihiro Sato, Hideaki Karasawa, Takeshi Aoki, Hirofumi Imoto, Naoki Tanaka, Kazuhiro Watanabe, Tomoya Abe, Munenori Nagao, Shinobu Ohnuma, Hiroaki Musha, Masanobu Takahashi, Fuyuhiko Motoi, Takeshi Naitoh, Chikashi Ishioka, Michiaki Unno
We report a case of a huge gastric gastrointestinal stromal tumor(GIST)that was safely resected followingpreoperative imatinib therapy. A 72-year-old woman was hospitalized with severe abdominal distension. Computed tomography revealed a 27×17 cm tumor in the left upper abdominal cavity. The patient was diagnosed with high risk GIST by EUS-FNA. We initiated preoperative adjuvant chemotherapy with imatinib to achieve a reduction of operative risks and functional preservation. After 6 months of chemotherapy, CT showed a reduction in the tumor size and the patient underwent partial gastrectomy and partial resection of the diaphragm...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28107764/endoscopic-ultrasound-guided-biliary-access-versus-precut-papillotomy-in-patients-with-failed-biliary-cannulation-a-retrospective-study
#9
Alexander Lee, Anupam Aditi, Yasser M Bhat, Kenneth F Binmoeller, Chris Hamerski, Oriol Sendino, Steve Kane, John P Cello, Lukejohn W Day, Medi Mohamadnejad, V Raman Muthusamy, Rabindra Watson, Jason B Klapman, Sri Komanduri, Sachin Wani, Janak N Shah
Background and aims Precut papillotomy is widely used after failed biliary cannulation. Endoscopic ultrasound (EUS)-guided biliary access techniques are newer methods to facilitate access and therapy in failed cannulation. We evaluated the impact of EUS-guided biliary access on endoscopic retrograde cholangiopancreatography (ERCP) success and compared these techniques to precut papillotomy. Patients and methods We retrospectively compared two ERCP cohorts. One cohort consisted of biliary ERCPs (n = 1053) attempted in patients with native papillae and surgically unaltered anatomy in whom precut papillotomy and/or EUS-guided biliary access were routinely performed immediately after failed cannulation...
February 2017: Endoscopy
https://www.readbyqxmd.com/read/28096828/intramural-esophageal-tumors
#10
Mariusz P Łochowski, Katarzyna Kozak, Marek Rębowski, Józef Kozak
INTRODUCTION: Intramural esophageal tumors (IET) are located between unchanged mucous membrane and muscularis mucosae. They can be both benign and malignant. AIM: To evaluate diagnostic and therapeutic difficulties of IET. MATERIAL AND METHODS: During the years 2010-2015, 11 patients with IET were treated in our clinic. Diagnostics included gastroscopy, computed tomography of the chest, endoscopic ultrasound (EUS) guided fine needle biopsy, and positron emission tomography (PET) of the esophagus in cases with no histopathological confirmation...
December 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28078128/endoscopic-ultrasound-in-pancreatic-cancer-innovative-applications-beyond-the-basics
#11
REVIEW
Joseph Yoo, C Andrew Kistler, Linda Yan, Andrew Dargan, Ali A Siddiqui
Endoscopic ultrasound (EUS) has become a mainstay in assisting in the diagnosis and staging of pancreatic cancer. In addition, EUS provides a modality to treat chronic pain through celiac plexus neurolysis. Currently, there is growing data and utilization of EUS in more diverse and innovative applications aimed at providing more sophisticated diagnostic, prognostic and therapeutic options for patients with pancreatic cancer. EUS delivery of chemotherapy, viral and biological vectors and fiducial markers may eventually revolutionize the way clinicians approach the care of a patient with pancreatic cancer...
December 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28066947/training-in-endoscopic-ultrasonography-an-asian-perspective
#12
REVIEW
Jennie Y Y Wong, Pradermchai Kongkam, Khek Yu Ho
Training of endoscopic ultrasonography (EUS) in Asia faces two major challenges: (i) the ever-increasing demand for skills to handle a growing range of interventional EUS procedures; and (ii) a continual shortage of EUS training programs. As the therapeutic application of EUS continues to expand, the need to train more new endosonographers and upgrade skills of existing ones has become more critical than ever before. A formal fellowship to acquire EUS knowledge and skills in an advanced endoscopy center has always been perceived as the best way of training novices, but such opportunities remain limited in most Asian countries...
January 9, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28063840/efficacy-and-safety-of-eus-guided-biliary-drainage-in-comparison-with-percutaneous-biliary-drainage-when-ercp-fails-a-systematic-review-and-meta-analysis
#13
REVIEW
Reem Z Sharaiha, Muhammad Ali Khan, Faisal Kamal, Amy Tyberg, Claudio R Tombazzi, Bilal Ali, Claudio Tombazzi, Michel Kahaleh
BACKGROUND AND AIMS: EUS-guided biliary drainage (EUS-BD) is increasingly used as an alternate therapeutic modality to percutaneous transhepatic biliary drainage (PTBD) for biliary obstruction in patients who fail ERCP. We conducted a systematic review and meta-analysis to compare the efficacy and safety of these 2 procedures. METHODS: We searched several databases from inception to September 4, 2016 to identify comparative studies evaluating the efficacy and safety of EUS-BD and PTBD...
January 4, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28008403/endoscopic-ultrasound-as-a-diagnostic-tool-in-a-case-of-obscure-hemobilia
#14
Monica A Konerman, Zishu Zhang, Cyrus Piraka
Hemobilia represents an uncommon cause of gastrointestinal bleeding that can present both diagnostic and therapeutic challenges. The evaluation of hemobilia typically involves cross-sectional imaging and endoscopic retrograde cholangiopancreatography (ERCP). There is limited data regarding the diagnostic utility of endoscopic ultrasound (EUS) in the evaluation of hemobilia. We present a case of a hepatic artery pseudoaneurysm as the etiology of hemobilia that was detected via EUS only. We conclude that EUS can serve as an important diagnostic tool in the evaluation of obscure hemobilia, especially in cases where imaging, ERCP, and percutaneous transhepatic cholangiography have been unsuccessful or inconclusive...
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28000629/effectiveness-of-contrast-enhanced-endoscopic-ultrasound-for-detecting-mural-nodules-in-intraductal-papillary-mucinous-neoplasm-of-the-pancreas-and-for-making-therapeutic-decisions
#15
Mitsuru Fujita, Takao Itoi, Nobuhito Ikeuchi, Atsushi Sofuni, Takayoshi Tsuchiya, Kentaro Ishii, Kentaro Kamada, Junko Umeda, Reina Tanaka, Ryosuke Tonozuka, Mitsuyoshi Honjo, Shuntaro Mukai, Fuminori Moriyasu
BACKGROUND AND OBJECTIVES: There have been few studies to date evaluating the effectiveness of contrast-enhanced endoscopic ultrasound (CE-EUS) for detecting mural nodules in patients with branch duct-type intraductal papillary mucinous neoplasm (BD-IPMN) of the pancreas. We aim to evaluate the effectiveness of CE-EUS for detecting mural nodules in BD-IPMN. PATIENTS AND METHODS: Of the 427 BD-IPMN patients, 21 patients (4.9%) in whom the presence of mural nodules was suggested by CE computed tomography (CT) or magnetic resonance imaging (MRI), or in whom the presence of nodule-like lesions as shown by fundamental EUS, were examined by CE-EUS...
November 2016: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/27995180/endoscopic-ultrasound-guided-fine-needle-aspiration-plus-kras-and-gnas-mutation-in-malignant-intraductal-papillary-mucinous-neoplasm-of-the-pancreas
#16
Barbara Bournet, Alix Vignolle-Vidoni, David Grand, Céline Roques, Florence Breibach, Jérome Cros, Fabrice Muscari, Nicolas Carrère, Janick Selves, Pierre Cordelier, Louis Buscail
Background:KRAS and GNAS mutations are common in intraductal papillary mucinous neoplasia of the pancreas (IPMN). The aims of this study were to assess the role of pre-therapeutic cytopathology combined with KRAS and GNAS mutation assays within cystic fluid sampled by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) to predict malignancy of IPMN. Patients and methods: We prospectively included 37 IPMN patients with clinical and/or imaging predictors of malignancy (men: 24; mean age: 69.5 years)...
December 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27931638/complications-of-diagnostic-and-therapeutic-endoscopic-ultrasound
#17
REVIEW
Sundeep Lakhtakia
Endoscopic Ultrasound (EUS) provides the unique opportunity to visualize, interrogate and intervene gastrointestinal (GI) luminal, mural or peri-luminal structures and pathology with negligible adverse effects. Diagnostic, upper GI and rectal EUS is feasible, extremely safe, and efficacious. Most EUS guided interventions are safe, effective and minimally invasive, compared to peers in the percutaneous radiological or surgical procedures. As with any endoscopic procedure, EUS and its guided interventions may be accompanied by adverse events...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27894187/endoscopic-ultrasound-guided-pancreatobiliary-endoscopy-in-surgically-altered-anatomy
#18
REVIEW
Pichamol Jirapinyo, Linda S Lee
Endoscopic retrograde cholangiopancreatography (ERCP) has become the mainstay of therapy for pancreatobiliary diseases. While ERCP is safe and highly effective in the general population, the procedure remains challenging or impossible in patients with surgically altered anatomy (SAA). Endoscopic ultrasound (EUS) allows transmural access to the bile or pancreatic duct (PD) prior to ductal drainage using ERCP-based techniques. Also known as endosonography-guided cholangiopancreatography (ESCP), the procedure provides multiple advantages over overtube-assisted enteroscopy ERCP or percutaneous or surgical approaches...
November 2016: Clinical Endoscopy
https://www.readbyqxmd.com/read/27891265/a-unique-case-of-pancreatic-mass-due-to-pancreatic-elastofibromatosis
#19
Abhinav Goyal, Deepanshu Jain, Ishfaq Bhat, Shailender Singh
Elastofibroma is a benign tumor of the musculoskeletal system characterized by the abnormal accumulation of elastinophilic fibers. It has been classically described for subscapular region but has been reported in several musculoskeletal sites over the years and rarely even in the GI tract but never in pancreas. We therefore present the case of a 45-year-old female who presented with intermittent abdominal pain. CT of abdomen revealed 1.4 cm pancreatic neck lesion without peripancreatic lymphadenopathy. Endoscopic ultrasound (EUS) guided FNA was nondiagnostic...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27863178/fine-needle-aspiration-biopsy-of-pancreatic-neuroendocrine-tumors-correlation-between-ki-67-index-in-cytological-samples-and-clinical-behavior
#20
Cristina Díaz Del Arco, J Miguel Esteban López-Jamar, Luis Ortega Medina, J Ángel Díaz Pérez, Ma Jesús Fernández Aceñero
BACKGROUND: Mitotic count in hematoxylin-eosin stained slides and Ki-67 index allow stratification of patients for prognosis and therapeutic decision making in pancreatic neuroendocrine tumors (PNETs). However, the utility of Ki-67 determination in cytological material and its association to PNET prognosis are under discussion. METHODS: We have retrospectively reviewed all cases of EUS-FNA cytology of pancreatic lesions performed in the Hospital Clínico San Carlos (Madrid) between 2006 and 2016...
January 2017: Diagnostic Cytopathology
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