Endoscopic Ultrasound最新文献

{"title":"A novel technique to prevent stent migration into the esophagus after EUS-guided hepaticogastrostomy (with video).","authors":"Yasuyuki Okada, Atsushi Nakai, Motoko Sei, Kaizo Kagemoto, Koichi Okamoto, Masahiro Sogabe, Hiroshi Miyamoto, Tetsuji Takayama","doi":"10.1097/eus.0000000000000206","DOIUrl":"10.1097/eus.0000000000000206","url":null,"abstract":"","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"15 4","pages":"326-328"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EUS <i>versus</i> magnetic resonance imaging for the diagnosis of focal pancreatic lesion in patients with chronic pancreatitis.","authors":"Jin-Hui Yi, Jin-Jie Xu, Jia-Yi Ma, Xiao-Xian Zeng, Teng Wang, Jia-Qi Wang, Song-Lin Zhang, Pei-Dong Han, Xiao-Yu Zhou, Xi He, Guang-Ming Chen, Ning-Li Chai, Zhao-Shen Li, Dan Wang, Liang-Hao Hu","doi":"10.1097/eus.0000000000000213","DOIUrl":"10.1097/eus.0000000000000213","url":null,"abstract":"<p><strong>Background and objectives: </strong>Distinguishing pancreatic cancer from inflammatory conditions in patients with chronic pancreatitis (CP) is challenging. Contrast-enhanced magnetic resonance imaging (MRI) and EUS are key diagnostic modalities, but their optimal use (alone or in combination) for accurate diagnosis remains unclear. This study aimed to compare the diagnostic efficacy of EUS and contrast-enhanced MRI for focal pancreatic lesions in CP patients.</p><p><strong>Methods: </strong>This single-center retrospective study enrolled CP patients with indeterminate focal pancreatic lesions detected by contrast-enhanced computed tomography. Patients underwent contrast-enhanced MRI, EUS, or both, and were categorized into 3 groups: MRI group, EUS group, and Combination group. Primary diagnoses were based on the reports of imaging or EUS-guided tissue acquisition, while final diagnoses were confirmed by surgical pathology or follow-up. The primary outcome was diagnostic performance.</p><p><strong>Results: </strong>A total of 103 patients were enrolled: 48 in the MRI group, 10 in the EUS group, and 45 in the Combination group. There were no statistically significant differences in diagnostic performance between these 2 independent groups. However, in the paired subgroup analysis, EUS demonstrated significantly higher accuracy than MRI (84.4% <i>vs.</i> 68.9%, <i>P</i> = 0.039). Further comparison revealed no significant difference in sensitivity (50.0% <i>vs.</i> 64.3%, <i>P</i> = 0.500), specificity (100.0% <i>vs.</i> 83.9%, <i>P</i> = 0.063), and accuracy (84.4% <i>vs.</i> 77.8%, <i>P</i> = 0.453) between EUS and the combination diagnosis.</p><p><strong>Conclusion: </strong>EUS was a superior individual diagnostic modality to MRI for evaluating focal pancreatic lesions in CP patients, and MRI did not provide significant additional diagnostic benefit over EUS alone.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"15 4","pages":"285-292"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13581383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EUS-guided injection sclerotherapy for gastroesophageal varices using direct endoscopic injection needle (with video).","authors":"Jun Li, Yilong Wang, Yingqun Zhou, Junshan Wang, Jiao Feng, Chao Huang, Feng Liu","doi":"10.1097/eus.0000000000000193","DOIUrl":"10.1097/eus.0000000000000193","url":null,"abstract":"","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"15 4","pages":"332-334"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13581369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare protrusion in the splenic flexure of colon.","authors":"Jin-Huan Lin, Ying-Jie Jiang, Li Wang, Pei-Dong Zhang, Tian-Hang Luo, Luo-Wei Wang, Wei Wang","doi":"10.1097/eus.0000000000000210","DOIUrl":"10.1097/eus.0000000000000210","url":null,"abstract":"","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"15 4","pages":"329-331"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13581364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel use of synthetic peptide hemostatic gel in conjunction with EUS-guided coil injection for the treatment of gastric varices: A single-center experience.","authors":"Christina S Gainey, Andrew Canakis, Todd H Baron","doi":"10.1097/eus.0000000000000179","DOIUrl":"10.1097/eus.0000000000000179","url":null,"abstract":"<p><strong>Background and objectives: </strong>Bleeding from gastric varices (GV) is severe and associated with high mortality. The standard endoscopic therapy, EUS-guided coil injection with cyanoacrylate glue (EUS-COIL + glue), is highly effective but carries a risk of systemic embolization. This study investigates the safety and efficacy of PuraStat, a synthetic peptide hemostatic gel that promotes clot formation without embolization risk, as an alternative injectate in conjunction with EUS-COIL.</p><p><strong>Methods: </strong>This was a single-center, retrospective analysis of 9 patients who underwent EUS-COIL + PuraStat for GV treatment (active bleeding, recent bleeding, or primary prophylaxis). Technical success was defined as successful coil deployment and reduction of Doppler flow; clinical success as bleeding cessation and/or absence of bleeding at 30 days. Secondary outcomes included adverse events (AEs) and re-intervention rates during follow-up.</p><p><strong>Results: </strong>Technical and clinical success was achieved in 100% of the procedures. There were no intraprocedural AEs, and only 1 minor (Grade II) postprocedural AE was recorded (10%). No patients experienced systemic embolization. One patient (11%) experienced recurrent bleeding at 54 days. Over a mean follow-up of 289 days, 56% of patients required repeat EUS-COIL procedures.</p><p><strong>Conclusion: </strong>EUS-COIL with PuraStat is a safe and highly effective treatment for GV in this small cohort, demonstrating excellent immediate success without the risk of systemic embolization associated with cyanoacrylate glue. While its use may necessitate earlier and more frequent surveillance and re-intervention, its superior safety profile makes it an attractive option. Larger comparative studies are warranted.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"15 4","pages":"281-284"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13581375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning curve of EUS-guided gastroenterostomy for the management of malignant gastric outlet obstruction: Data from a bicentric retrospective study.","authors":"Angelica Toppeta, Marie Philippart, Jean-Philippe Ratone, Antoine Assaf, Mariola Marx, Élodie Romailler, Meddy Dalex, Marc Giovannini, Solène Hoibian, Yanis Dahel, Francesco Martini, Sébastien Godat, Fabrice Caillol","doi":"10.1097/eus.0000000000000221","DOIUrl":"10.1097/eus.0000000000000221","url":null,"abstract":"<p><strong>Background and objectives: </strong>EUS-guided gastroenterostomy (EUS-GE) is a promising alternative for managing malignant gastric outlet obstruction (GOO). This study aimed to analyze the learning curve (LC) for EUS-GE.</p><p><strong>Methods: </strong>This retrospective European bicentric study included 96 patients with malignant GOO who underwent EUS-GE (April 2021 to August 2024) using the wireless EUS-guided gastroenterostomy simplified technique (WEST) or modified WEST. The primary outcome was to define the LC for each center through a composite score based on the clinical success rate, severe adverse events (III-IV per the AGREE classification), and procedural time. Secondary outcomes included the technical success rate, length of hospital stay, and resumption/initiation of chemotherapy.</p><p><strong>Results: </strong>A total of 218 consecutive patients with GOO were screened across both centers. Twenty-seven patients were excluded because of surgically altered anatomy and/or benign GOO, leaving 191 patients with malignant GOO in the treatment-flow cohort. Among these, 96 patients underwent EUS-GE (Center 1: <i>n</i> = 53; Center 2: <i>n</i> = 43), whereas 95 patients underwent endoscopic duodenal stenting (Center 1: <i>n</i> = 74; Center 2: <i>n</i> = 21); no patient underwent surgical gastrojejunostomy during the study period. Ninety-six patients (54% women; mean age 68 years) were included. The technical and clinical success rates were 93% (<i>n</i> = 89/96) and 89% (<i>n</i> = 80/89), respectively. Severe complications occurred in 6% of patients, with a 1% mortality rate. The main cause of technical failure was misdeployment of the lumen-apposing metal stent, with the distal flange deployed between the stomach and the intestinal wall in 83% of cases (<i>n</i> = 5). The LC suggested a stabilization phase after approximately 20 procedures/center. The median length of stay was 8 days (IQR 6-10), and 69% (95% CI 55.6-75.6) of patients resumed or initiated chemotherapy.</p><p><strong>Conclusions: </strong>EUS-GE is a complex procedure that, at the team level, appears to reach a stable performance phase after approximately 20 procedures, with high clinical success rates and low complication rates.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"15 4","pages":"273-280"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13581385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful bridging of disconnected pancreatic duct in a patient with pancreas divisum using triple combined drainage (with videos).","authors":"Mingkun Qiu, Wenrui Wang, Guoming Zhang, Zefeng Xing, Ning Zhong, Zhen Li","doi":"10.1097/eus.0000000000000188","DOIUrl":"10.1097/eus.0000000000000188","url":null,"abstract":"","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"15 4","pages":"321-323"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13581377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal timing for hepatic cyst intervention: Predictive factors for complete resolution after ethanol sclerotherapy.","authors":"Yoonchan Lee, Dong-Wan Seo, Sung Hyun Cho, Gunn Huh, Dongwook Oh, Tae Jun Song","doi":"10.1097/eus.0000000000000208","DOIUrl":"10.1097/eus.0000000000000208","url":null,"abstract":"<p><strong>Background and objectives: </strong>The optimal timing of ethanol sclerotherapy and predictors of complete resolution (CR) in patients with symptomatic hepatic cysts remain unclear. This study aimed to identify clinical and procedural predictors of CR and to determine a volume-based threshold that may guide patient selection.</p><p><strong>Methods: </strong>We retrospectively analyzed 307 patients who underwent percutaneous catheter drainage-guided or EUS-guided ethanol sclerotherapy between 2003 and 2023. CR was defined as <5% of baseline cyst volume. Receiver operating characteristic analysis identified a volume threshold for CR, and multivariable logistic regression was used to determine independent predictors.</p><p><strong>Results: </strong>CR was achieved in 54.4% of patients during a mean follow-up of 24.7 ± 21.1 months. An initial cyst volume of 233 mL (≈7-8 cm in diameter) was identified by receiver operating characteristic analysis as a threshold associated with CR (area under the curve 0.626; sensitivity 50.9%; specificity 75.0%). CR rates were significantly higher in cysts <233 mL than in larger cysts (70.6% <i>vs.</i> 44.1%, <i>P</i> < 0.001). In multivariable analysis, cyst volume ≥233 mL (adjusted odds ratio [aOR] 0.27, 95% confidence interval [CI] 0.15-0.48) and elevated alanine aminotransferase >30 U/L (aOR 0.16, 95% CI 0.05-0.50) were independently associated with nonresolution, as was diabetes mellitus (aOR 0.12, 95% CI 0.02-0.62), a finding requiring external validation given the small diabetic subgroup (<i>n</i> = 11). Treatment modality (EUS <i>vs</i>. percutaneous catheter drainage) was not associated with treatment success (<i>P</i> = 0.678).</p><p><strong>Conclusion: </strong>Initial hepatic cyst volume is an important factor influencing treatment outcome. The 233 mL threshold may inform the timing of intervention alongside symptoms and patient-specific factors.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"15 4","pages":"266-272"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13581355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare metastatic clear cell renal cell carcinoma to pancreas and duodenum revealed by EUS-guided fine-needle biopsy.","authors":"Xiaorong Tian, Wei Du, Yuyan Zhou, Ang Li, Yiting Wang, Zhenghui Yang, Zhicheng Yang, Deyu Zhang, Haojie Huang, Zhendong Jin","doi":"10.1097/eus.0000000000000185","DOIUrl":"10.1097/eus.0000000000000185","url":null,"abstract":"","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"15 4","pages":"318-320"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13581349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EUS-guided hepatico-gastrostomy followed by antegrade digital cholangioscopy and laser lithotripsy for a large biliary stone in surgically altered anatomy (with video).","authors":"Amine Achemlal, Shrikant Mukewar, Bhushan Bhaware, Shubankar Godbole, Saurabh Mukewar","doi":"10.1097/eus.0000000000000220","DOIUrl":"10.1097/eus.0000000000000220","url":null,"abstract":"","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"15 4","pages":"324-325"},"PeriodicalIF":4.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13581361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}