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Pancreatic cancer, endoscopic ultrasound, ercp

Kazuya Matsumoto, Yohei Takeda, Takumi Onoyama, Soichiro Kawata, Hiroki Kurumi, Masaru Ueki, Norimasa Miura, Hajime Isomoto
Pancreatic cancer is the fifth leading cause of cancer death and has the lowest survival rate of any solid cancer. Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA) is currently capable of providing a cytopathological diagnosis of pancreatic malignancies with a higher diagnostic power, with a sensitivity and specificity of 85%-89% and 98%-99%, compared to pancreatic juice cytology (PJC), whose sensitivity and specificity are only 33.3%-93% and 83.3%-100%. However, EUS-FNA is not effective in the cases of carcinoma in situ and minimally invasive carcinoma because both are undetectable by endoscopic ultrasonography, although PJC is able to detect them...
September 15, 2016: World Journal of Gastrointestinal Oncology
Farah Adel, José Manuel Ramia, Luis Gijón, Roberto de la Plaza-Llamas, Vladimir Arteaga-Peralta, Carmen Ramiro-Perez
BACKGROUND: Cystic echinococcosis is a zoonosis caused by larvae of the parasite Echinococcus that is endemic in many countries of the Mediterranean area. It can affect any organ, with the most common sites being liver (70%) and lung (20%). Splenic hydatid disease, despite being rare, is the third most common location. Other locations such as bone, skin, or kidney are exceptional. OBJECTIVE: To present our experience in extrahepatic and extrapulmonary hydatidosis...
September 5, 2016: Cirugia y Cirujanos
Alexandra Kalogeraki, Georgios Z Papadakis, Dimitrios Tamiolakis, Iliana Karvela-Kalogeraki, Mihailos Karvelas-Kalogerakis, John Segredakis, Michael Papadakis, Eleni Moustou, Galateia Datseri, Maria Tzardi
Solid masses of the pancreas represent a variety of benign and malignant neoplasms of the exocrine and endocrine tissues of the pancreas. A tissue diagnosis is often required to direct therapy in the face of uncertain diagnosis or if the patient is not a surgical candidate either due to advanced disease or comorbidities. Endoscopic ultrasound (EUS) is a relatively new technology that employs endoscopy and high-frequency ultrasound (US). EUS involves imaging of the pancreatic head and the uncinate from the duodenum and imaging of the body and tail from the stomach...
January 2016: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
Mouen A Khashab, Schalk Van der Merwe, Rastislav Kunda, Mohamad H El Zein, Anthony Y Teoh, Fernando P Marson, Carlo Fabbri, Ilaria Tarantino, Shyam Varadarajulu, Rani J Modayil, Stavros N Stavropoulos, Irene Peñas, Saowanee Ngamruengphong, Vivek Kumbhari, Joseph Romagnuolo, Raj Shah, Anthony N Kalloo, Manuel Perez-Miranda, Everson L Artifon
BACKGROUND AND AIMS: Endoscopic ultrasound-guided biliary drainage (EUS-BD) has emerged as an alternative to traditional radiologic and surgical drainage procedures after failed endoscopic retrograde cholangiopancreatography (ERCP). However, prospective multicenter data are lacking. The aims of this study were to prospectively assess the short- and long-term efficacy and safety of EUS-BD in patients with malignant distal biliary obstruction. PATIENTS AND METHODS: Consecutive patients at 12 tertiary centers (5 US, 5 European, 1 Asian, 1 South American) with malignant distal biliary obstruction and failed ERCP underwent EUS-BD...
April 2016: Endoscopy International Open
Stephen Y Oh, Shayan Irani, Richard A Kozarek
Pancreatic adenocarcinoma is the fourth leading cause of cancer-related death in the United States. Due to the aggressive tumor biology and late manifestations of the disease, long-term survival is extremely uncommon and the current 5-year survival rate is 7%. Over the last two decades, endoscopic ultrasound (EUS) has evolved from a diagnostic modality to a minimally invasive therapeutic alternative to radiologic procedures and surgery for pancreatic diseases. EUS-guided celiac plexus intervention is a useful adjunct to conventional analgesia for patients with pancreatic cancer...
April 10, 2016: World Journal of Gastrointestinal Endoscopy
Erik Bowman, Jacob Greenberg, Michael Garren, Nalini Guda, Brian Rajca, Mark Benson, Patrick Pfau, Anurag Soni, Andrew Walker, Deepak Gopal
BACKGROUND: Patients with Roux-en-Y gastric bypass (RYGB) develop pancreatobiliary issues after surgery. Endoscopic management via the conventional route with endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) is quite limited due to the altered anatomy. Laparoscopic-assisted ERCP (LA-ERCP) via the excluded stomach has been highly successful. Reported use of laparoscopic-assisted EUS (LA-EUS) is extremely rare. METHODS: A retrospective review was conducted at two tertiary referral centers for cases that involved laparoscopic-assisted ERCP and EUS...
October 2016: Surgical Endoscopy
Ryuichi Yamamoto, Masatomo Takahashi, Yasuyo Osafune, Katsuya Chinen, Shingo Kato, Sumiko Nagoshi, Koji Yakabi
AIM: To evaluate the efficacy and safety of single-step endoscopic placement of self-expandable metallic stents (SEMS) for treatment of obstructive jaundice. METHODS: A retrospective study was performed among 90 patients who underwent transpapillary biliary metallic stent placement for malignant biliary obstruction (MBO) between April 2005 and October 2012. The diagnosis of primary disease and MBO was based on abdominal ultrasound, computed tomography, magnetic resonance imaging, endoscopic ultrasound, endoscopic retrograde cholangiopancreatography with brush cytology, biopsy, and/or a combination of these modalities...
July 25, 2015: World Journal of Gastrointestinal Endoscopy
C Rinaldi A Lesmana, Khek Yu Ho, Laurentius A Lesmana
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a common technique for assessing the pancreas and the biliary system; however, the potential complications have raised concern among endoscopists and patients. Recently, the need of endoscopic ultrasound (EUS) as an additional tool of assessment before the ERCP procedure has been increasing. The need of EUS in developing countries is still a matter of debate regarding the cost, investment, and training. Here, we report the significant impact of EUS on several unselected interesting cases of pancreatobiliary disorders...
May 2015: Case Reports in Gastroenterology
Vishal Sharma, Surinder S Rana, Deepak K Bhasin
Endoscopic ultrasound (EUS) has emerged as an important diagnostic and therapeutic modality in the field of gastrointestinal endoscopy. EUS provides access to many organs and lesions which are in proximity to the gastrointestinal tract and thus giving an opportunity to target them for therapeutic and diagnostic purposes. This modality also provides a real time opportunity to target the required area while avoiding adjacent vascular and other structures. Therapeutic EUS has found role in management of pancreatic fluid collections, biliary and pancreatic duct drainage in cases of failed endoscopic retrograde cholangiopancreatography, drainage of gallbladder, celiac plexus neurolysis/blockage, drainage of mediastinal and intra-abdominal abscesses and collections and in targeted cancer chemotherapy and radiotherapy...
June 10, 2015: World Journal of Gastrointestinal Endoscopy
Michele Tedeschi, Francesco Vittore, Pasquale Di Fronzo, Angela Gurrado, Giuseppe Piccinni, Mario Testini
INTRODUCTION: Autoimmune pancreatitis is now a defined entity and it could mimic a pancreatic malignancy. True oncological emergencies in pregnant patients are rare. CASE REPORT: A 39 years-old pregnant woman was admitted to our emergency unit due to right upper quadrant abdominal pain and evidence of obstructive jaundice. Since computed tomography-scan and endoscopic retrograde cholangiopancreatography are contraindicated in pregnant woman, a cholangio-Nuclear Magnetic Resonance was performed, confirming the biliary tract dilatation with stenosis of the intrapancreatic portion of the common bile duct and a shaded image of a mass in the pancreatic head...
January 2015: Annali Italiani di Chirurgia
Varayu Prachayakul, Pitulak Aswakul
Endoscopic retrograde cholangiopancreatography had been a treatment modality of choice for both benign and malignant biliary tract obstruction for more than half century, with a very high clinical success rate and low complications. But in certain circumstances, such as advanced and locally advanced pancreatobiliary malignancies (pancreatic cancer, cholangiocarcinoma, ampullary tumor) and tight benign strictures, endoscopic retrograde cholangiopancreatography (ERCP) fails. Up to this point, the only alternative interventions for these conditions were percutaneous transhepatic biliary drainage or surgery...
January 16, 2015: World Journal of Gastrointestinal Endoscopy
Hemanth Gavini, Jeffrey H Lee
Over the last 2 decades, endoscopic ultrasound (EUS) has evolved from a noninvasive diagnostic tool to a combined diagnostic and therapeutic modality. The use of EUS complementary to endoscopic retrograde cholangiopancreatography (ERCP) has made possible biliary and pancreatic drainage in situations where conventional ERCP is unsuccessful or unlikely to be feasible. The degree of proximity to the pancreas achieved during the procedure has enabled therapeutic interventions such as drainage of peripancreatic fluid collections, pancreatic cyst ablation, and pancreatic cancer therapy...
March 2015: Journal of Clinical Gastroenterology
M Ashkar, T B Gardner
AIM: Since its introduction, endoscopic ultrasonography (EUS) has been increasingly gaining more attention for diagnosing various gastrointestinal conditions. We aim to systematically review the literature and highlight the benefit of using EUS in different pancreatic diseases by primarily reviewing its importance in diagnosing, treating pancreatic pathologies, comparing its accuracy to other modalities and determining its limitations and complications. METHODS: Using defined (MeSH) terms and keywords; two reviewers conducted a MEDLINE search through August 2014, in addition to manually searching relevant bibliographies cited in the included studies...
December 2014: Minerva Gastroenterologica e Dietologica
John J Kim, Sukhpreet Walia, Scott H Lee, Bhavesh Patel, Madhavi Vetsa, Yan Zhao, Wichit Srikureja, Loren Laine
BACKGROUND: In jaundiced patients with suspected pancreatic cancer, endoscopic retrograde cholangiopancreatography (ERCP) with biliary stent is frequently performed prior to histologic diagnosis by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). AIMS: To compare the accuracy of jaundiced patients undergoing EUS-FNA for a pancreatic mass with or without a biliary stent. METHODS: Consecutive patients with a pancreatic mass and jaundice who underwent EUS-FNA between 4/2005 and 4/2013 were identified...
February 2015: Digestive Diseases and Sciences
Juana Gonzalo-Marin, Juan Jose Vila, Manuel Perez-Miranda
Endoscopic ultrasonography (EUS) with or without fine needle aspiration has become the main technique for evaluating pancreatobiliary disorders and has proved to have a higher diagnostic yield than positron emission tomography, computed tomography (CT) and transabdominal ultrasound for recognising early pancreatic tumors. As a diagnostic modality for pancreatic cancer, EUS has proved rates higher than 90%, especially for lesions less than 2-3 cm in size in which it reaches a sensitivity rate of 99% vs 55% for CT...
September 15, 2014: World Journal of Gastrointestinal Oncology
Zora Vukobrat-Bijedic, Azra Husic-Selimovic, Nina Bijedic, Srdjan Gornjakovic, Amela Sofic, Bisera Gogov, Ivana Bjelogrlic, Amila Mehmedovic, Sanjin Glavas
THE GOAL: The goal of this work was to give advantage to EUS as endoscopic method in diagnosis and following therapeutic treatment of pancreatic cancer in relation to radiological methods of CT and CTA. MATERIAL AND METHODS: The study included 49 patients, 20 women and 29 men hospitalized at the Clinic for gastroenterohepatology, due to suspicion on pancreatic cancer during observed 2 years period. All cancers were histologically and cytologically confirmed. The patients underwent ERCP as a mandatory part of staging and all patients underwent endoscopic ultrasound as well as CT or CT angiography...
June 2014: Acta Informatica Medica: AIM
Erik-Jan Wamsteker
PURPOSE OF REVIEW: The purpose of this review is to provide an update on the diagnosis and treatment of pancreatic disorders using endoscopy. RECENT FINDINGS: The role of endoscopy in the diagnosis and management of pancreatic disorders continues to increase in importance. The use of post-endoscopic retrograde cholangio-pancreatography (ERCP) provides therapy for many pancreatic disorders, including in the treatment of pancreatitis, its complications and pancreatic neoplasia...
September 2014: Current Opinion in Gastroenterology
Tomoyuki Ushijima, Yoshinobu Okabe, Yusuke Ishida, Gen Sugiyama, Yu Sasaki, Kei Kuraoka, Makiko Yasumoto, Tomoki Taira, Yoshiki Naito, Masamichi Nakayama, Osamu Tsuruta, Michio Sata
With the advances in the multidisciplinary treatment of pancreatic cancer (PC) over the last few years, it is crucial to obtain a histopathological diagnosis prior to treatment. Histopathological diagnosis for unresectable PC is currently performed with endoscopic retrograde cholangiopancreatography (ERCP) in combination with endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). We retrospectively assessed the results of these two methods and investigated diagnostic performance according to the location of the lesion and the complications...
July 2014: Molecular and Clinical Oncology
Ziad T Awad
UNLABELLED: Laparoscopic pancreaticoduodenectomy is a technically demanding procedure. In this video, we demonstrate the technical aspects of performing the procedure. In a 50-year-old male with ascending cholangitis, endoscopic retrograde cholangiopancreatography was unsuccessful, and percutaneous transhepatic cholangiography was carried out for biliary decompression. Endoscopic ultrasound plus fine-needle aspiration showed pancreatic head adenocarcinoma. The procedure was carried out using five trocars, and extensive lymphadenectomy was undertaken...
October 2014: Annals of Surgical Oncology
Vinay Dhir, Rajesh Kumar Paramasivam, Josef Carlo Lazaro, Amit Maydeo
Therapeutic endoscopic ultrasound (EUS) became possible after the advent of the linear echoendoscope and the EUS guided fine needle aspiration. Over the past two decades, the indications for therapeutic EUS have expanded and evidence regarding its utility has been steadily accumulating. Randomized studies have shown EUS to be effective for cancer pain relief (celiac plexus neurolysis), pancreatic fluid collection drainage, and biliary drainage. Prospective studies have shown EUS-guided biliary drainage to be safe and effective in patients with failed ERCP...
September 2014: Expert Review of Gastroenterology & Hepatology
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