Endoscopic ultrasound guided interventional procedures

• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: Endosonography PANCREATIC PSEUDOCYST Celiac plexus CHOLEDOCHOSTOMY CHOLECYSTOSTOMY PHOTOCHEMOTHERAPY Abdominal abscess Common bileduct PANCREATIC duct ENDOSCOPIC ultrasound-guidedfine needle aspiration
• 年，卷（期）: 2015,（6）
• 页码范围: 628-642
• 页数: 15页
• 分类号: R

摘要

Endoscopic ultrasound （EUS） has emerged as animportant diagnostic and therapeutic modality in thefield of gastrointestinal endoscopy. EUS provides accessto many organs and lesions which are in proximity tothe gastrointestinal tract and thus giving an opportunityto target them for therapeutic and diagnostic purposes.This modality also provides a real time opportunityto target the required area while avoiding adjacentvascular and other structures. Therapeutic EUS hasfound role in management of pancreatic fluid collections,biliary and pancreatic duct drainage in cases of failedendoscopic retrograde cholangiopancreatography,drainage of gallbladder, celiac plexus neurolysis/blockage,drainage of mediastinal and intra-abdominal abscessesand collections and in targeted cancer chemotherapyand radiotherapy. Infact, therapeutic EUS has emergedas the therapy of choice for management of pancreaticpseudocysts and recent innovations like fully coveredremovable metallic stents have improved resultsin patients with organised necrosis. Similarly, EUSguided drainage of biliary tract and pancreatic ducthelps drainage of these systems in patients with failedcannulation, inaccessible papilla as with duodenal/gastric obstruction or surgically altered anatomy. EUSguided gall bladder drainage is a useful emergentprocedure in patients with acute cholecystitis who arenot fit for surgery. EUS guided celiac plexus neurolysisand blockage is more effective and less morbid vis-à-visthe percutaneous technique. The field of interventionalEUS is rapidly advancing and many more interventionsare being continuously added. This review focuses onthe current status of evidence vis-à-vis the establishedindications of therapeutic EUS.