Therapeutic Endoscopic Ultrasonography
1Department of Surgery, University of Sao Paulo, Rua Guimaraes Passos 260, Vila Mariana, Sao Paulo, Brazil
2Gastroenterology and Endoscopy Department, Paoli-Calmettes Institute, 232 Boulevard Sainte Marguerite, 13273 Marseille Cedex 9, France
3Endoscopy Center, Shenjing Hospital of China Medical University, 36 Sanhao Street, Shenyang, China
4Endoscopy Unit, Gastroenterology Department, Complejo Hospitalario de Navarra, C/Irunlarrea, 331008 Pamplona, Spain
Therapeutic Endoscopic Ultrasonography
Description
Endoscopy ultrasonography is an important tool applied to oncology in general. This technology began few decades ago and has been used in different areas besides gastroenterology/oncology. Endoscopic ultrasound (EUS) was developed as a diagnostic modality but rapidly gained a role for a variety of therapeutic applications. EUS has been used increasingly for drainage of pancreatic pseudocysts, treatment of cystic lesions of the pancreas, EUS-guided cholangiopancreatography, localized therapy for pancreatic tumors, and treatment of subepithelial lesions and gastric varices.
Attempts to perform therapy guided by endoscopic ultrasound (EUS) are rare. Some new indications for interventional and therapeutic endoscopic procedures performed under EUS control have been developed in areas that have been purely surgical for many years. Indications, procedures, and related tools for EUS-guided endosurgery are described, all of which are experimental but may open a new corridor for endoscopists to enter a variety of transluminal procedures in real time without soiling the peritoneal or mediastinal cavity. Potential topics include, but are not limited to:
- EUS biliary drainage (choledochoduodenostomy, hepaticogastrostomy, rendezvous, antegrade technique)
- EUS-guided pseudocysts
- EUS-guided vascular procedures
- EUS-guided urologic procedures
- EUS-guided intratumoral therapy
- EUS-guided papillotomy
- EUS-guided celiac alcoholization
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