Endoscopic Ultrasound最新文献

{"title":"EUS-guided gastroenterostomy using a parallel enteric tube for luminal distension: Prospective multicenter procedural standardization (with video).","authors":"Carlos Chavarría, Vanessa Martín-Álvarez, Jose Ramón Aparicio, Jose Carlos Subtil, Francisco Javier Garcia-Alonso, Juan J Vila, Belén Martinez-Moreno, Victoria Busto Bea, Carlos de la Serna-Higuera, Manuel Perez-Miranda","doi":"10.1097/eus.0000000000000123","DOIUrl":"10.1097/eus.0000000000000123","url":null,"abstract":"<p><strong>Background and objectives: </strong>The EUS-guided gastroenterostomy (EUS-GE) technique remains nonstandardized. We primarily aimed at standardizing parallel enteric tube (PET)-assisted EUS-GE, secondarily assessing reproducibility and outcomes.</p><p><strong>Methods: </strong>This prospective multicenter study included consecutive adult patients with unresectable malignant gastric outlet obstruction undergoing primary EUS-GE between August 2019 and April 2021. Hierarchical task analysis predefined procedural steps into tasks and subtasks. Subtasks were further categorized into essential (performed in all centers and in more than 85% of the procedures) or optional. Subtask methodology was considered established if performed similarly in all centers or variable if not. Procedure times, injected fluid volume, accessories, adverse events (AEs), and outcomes were recorded.</p><p><strong>Results: </strong>Seven endoscopists performed EUS-GE in 65 patients (50.8% male, median [interquartile range] age 77.5 [65.7-86.5] years). EUS-GE was categorized into 4 tasks (enteric tube placement, endoscope exchange, small bowel distention plus targeting, lumen-apposing metal stent placement) and 10 subtasks (7 essential, 3 optional). Five essential subtasks involved an established methodology (guidewire and PET placement, endoscope exchange, delivery system insertion, and lumen-apposing metal stent deployment).Technical and clinical success rates were 98.5% and 83.3%, respectively. AEs occurred in 10 (15.4%) patients. Success and AE rates were not different between expert and nonexperts. Procedure time was longer (35 [30.6-43.7] <i>vs</i>. 21.8 [16.4-29.5] minutes, <i>P</i> < 0.001) and injected fluid volume higher (510 [439-870] <i>vs</i>. 415 [255-480] mL, <i>P</i> = 0.01) in nonexperts.</p><p><strong>Conclusions: </strong>PET-assisted EUS-GE was standardized, identifying its key steps and technique variants. PET-assisted EUS-GE appears to be a reproducible procedure among advanced endoscopists with different levels of experience.(ClinicalTrials identification no. NCT04660695).</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 3","pages":"129-136"},"PeriodicalIF":5.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046276","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":"An unusual case of recurrent acute pancreatitis successfully treated via precut papillotomy (with video).","authors":"Shi-Han Chen, Jia-Su Li, Wei Zhu, Yan Chen, Jie Chen","doi":"10.1097/eus.0000000000000118","DOIUrl":"10.1097/eus.0000000000000118","url":null,"abstract":"","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 3","pages":"151-152"},"PeriodicalIF":5.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050935","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":"Pioneering minimally invasive solutions for chronic appendicitis: EUS-assisted endoscopic appendicitis therapy (with video).","authors":"Xiao-Hai Huang, Yu-Chieh Weng, Yang-Bor Lu","doi":"10.1097/eus.0000000000000121","DOIUrl":"10.1097/eus.0000000000000121","url":null,"abstract":"","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 3","pages":"158-159"},"PeriodicalIF":5.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050967","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":"The i-EUS consensus on EUS-guided gallbladder drainage: A 3-step modified Delphi approach.","authors":"Antonio Facciorusso, Cecilia Binda, Stefano Francesco Crinò, Andrea Lisotti, Marco Spadaccini, Arnaldo Amato, Lucio Carrozza, Fausto Catena, Lorenzo Cobianchi, Chiara Coluccio, Edoardo Forti, Lorenzo Fuccio, Dario Ligresti, Marcello Fabio Maida, Aurelio Mauro, Stefano Mazza, Vincenzo G Mirante, Giacomo E M Rizzo, Edoardo Troncone, Giuseppe Vanella, Emilija Rakichevikj, Andrea Anderloni, Carlo Fabbri, Ilaria Tarantino, Luca Ansaloni, Elia Armellini, Roberta Badas, Carmelo Barbera, Debora Berretti, Ivo Boskoski, Lorenzo Camellini, Vincenzo Cennamo, Luigi Cugia, Giovanna Del Vecchio Blanco, Germana De Nucci, Roberto Di Mitri, Marta Di Pisa, Francesco Ferrara, Alessandro Fugazza, Pedro Moutinho-Ribeiro, Daniele Macor, Emanuele Marciano, Massimiliano Mutignani, Manuel Perez Miranda, Enrico Piras, Valeria Pollino, Alessandro Ettore Redaelli, Antonella Scarcelli, Cristiano Spada, Mario Traina, Alberto Tringali, Giovanna Venezia, Pietro Fusaroli","doi":"10.1097/eus.0000000000000128","DOIUrl":"10.1097/eus.0000000000000128","url":null,"abstract":"<p><strong>Background and objective: </strong>EUS-guided gallbladder drainage (EUS-GBD) has emerged as a viable alternative for patients with acute cholecystitis who are unfit for surgery. However, standardized guidelines for its indications, techniques, and management remain limited. The objective of this study is to develop evidence-based consensus recommendations for EUS-GBD in benign and malignant conditions, aimed at guiding clinical decision-making and improving patient outcomes.</p><p><strong>Methods: </strong>A 3-step modified Delphi process was used by the Interventional Endoscopy and Ultrasound Group, involving multidisciplinary experts in gastroenterology, surgery, and radiology. Four task forces conducted systematic literature reviews and generated PICO (Patients, Interventions, Comparator, and Outcomes)-formatted clinical questions. Evidence was graded using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) system, and consensus was defined as ≥80% agreement among panelists.</p><p><strong>Results: </strong>Twenty-two clinical questions were addressed, covering indications, timing, techniques, device selection, procedural aspects, and postprocedural care for EUS-GBD. Recommendations include the preferential use of EUS-GBD over percutaneous and transpapillary approaches in high-risk patients, early intervention in select cases, the use of lumen-apposing metal stents, and tailored postprocedural strategies. All recommendations were conditional, except for one strong recommendation in favor of EUS-GBD over other modalities, supported by moderate-quality evidence.</p><p><strong>Conclusions: </strong>This consensus offers a comprehensive, multidisciplinary guideline for the safe and effective use of EUS-GBD in clinical practice. These recommendations aim to standardize care and support future research in this rapidly evolving field.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 3","pages":"106-119"},"PeriodicalIF":5.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050941","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":"Recent research progress of photoacoustic endoscopy in the digestive system.","authors":"Kai Zhang, Nan Ge, Lufan Shen, Fei Yang, Jianjun Qiu, Jintao Guo, Kaixuan Wang, Sheng Wang, Fan Yang, Shiyun Sheng, Tianan Jiang, Zhendong Jin, Siyu Sun","doi":"10.1097/eus.0000000000000127","DOIUrl":"10.1097/eus.0000000000000127","url":null,"abstract":"","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 3","pages":"99-105"},"PeriodicalIF":5.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046337","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 case of intraoperative intraductal ultrasonography-guided tumor-free resection margin in hilar cholangiocarcinoma (with videos).","authors":"Man Luo, Yaowei Hu, Yue Liu, Xuan Meng, Hongguang Wang","doi":"10.1097/eus.0000000000000122","DOIUrl":"10.1097/eus.0000000000000122","url":null,"abstract":"","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 3","pages":"153-155"},"PeriodicalIF":5.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050949","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 case of hepatic epithelioid hemangioendothelioma diagnosed by EUS-guided fine-needle biopsy (with videos).","authors":"Yating Wang, Beiyao Zhang, Dongqiang Zhao","doi":"10.1097/eus.0000000000000111","DOIUrl":"10.1097/eus.0000000000000111","url":null,"abstract":"","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 2","pages":"94-97"},"PeriodicalIF":4.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093208","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":"Technical tips for EUS for pancreatic lesions in patients undergoing total gastrectomy and Roux-en-Y reconstruction (with videos).","authors":"Tatsuya Koshitani, Kumpei Kadosaka, Hiroshi Takihara, Takahiro Takemoto","doi":"10.1097/eus.0000000000000104","DOIUrl":"10.1097/eus.0000000000000104","url":null,"abstract":"","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 2","pages":"89-90"},"PeriodicalIF":4.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093324","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":"Long-term outcomes of EUS-guided antegrade intervention with transmural and transanastomotic plastic stenting for benign bilioenteric anastomotic strictures (with video).","authors":"Gunn Huh, Taehyung Lee, Jinhee Kwon, Ce Hwan Park, John J Vargo, Steven A Edmundowicz, Sunguk Jang, Do Hyun Park","doi":"10.1097/eus.0000000000000112","DOIUrl":"10.1097/eus.0000000000000112","url":null,"abstract":"<p><strong>Background and objectives: </strong>Recurrence of benign bilioenteric anastomotic strictures (BAS) is common after enteroscopy-assisted endoscopic retrograde cholangiopancreatography (ERCP), percutaneous intervention, or EUS-guided antegrade intervention (EUS-AI). This study evaluated the long-term outcomes of EUS-AI with transmural and transanastomotic stenting (TAS) following EUS-guided hepaticogastrostomy (HGS) in BAS.</p><p><strong>Methods: </strong>Consecutive patients with BAS undergoing EUS-AI with or without TAS after failed deep enteroscopy between January 2016 and June 2023 were retrospectively analyzed. The primary outcome was BAS recurrence rate after TAS removal; secondary outcomes included technical success of AI, on demand endoscopic procedure (DP) rate, the time to DP, and adverse events.</p><p><strong>Results: </strong>Among 38 patients who underwent EUS-HGS, EUS-AI succeeded in 34 (89.5%), and 28 (73.7%) proceeded to TAS. The median follow-up duration for 28 patients with TAS was 53.4 months (IQR, 22.8-85.2). During TAS placement without regular stent change, DP occurred in 43% (12/28) at a median time of 23 months. The 1-year procedure-free rate was 81.2%. After TAS removal (<i>n</i> = 12), with a median stent duration of 21.6 months, there was no BAS recurrence (0%).</p><p><strong>Conclusion: </strong>EUS-AI with indwelling TAS, without regular stent change, may offer promising long-term outcomes for BAS by reducing recurrence.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 2","pages":"79-84"},"PeriodicalIF":4.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093239","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 portal pressure gradient measurement for evaluating the severity of portal hypertension: A retrospective analysis.","authors":"Rongkun Luo, Mingcong Chen, Huanyuan Lu, Rui Zhang, Hongwu Luo, Yinghong Liu, Xunyang Liu, Feizhou Huang, Gang Deng, Zhao Lei","doi":"10.1097/eus.0000000000000115","DOIUrl":"10.1097/eus.0000000000000115","url":null,"abstract":"<p><strong>Background and objectives: </strong>EUS-guided portal pressure gradient (EUS-PPG) measurement has been proposed as a novel direct manometry to quantify portal hypertension. This study aimed to explore the ability of EUS-PPG measurements to evaluate the severity of portal hypertension.</p><p><strong>Methods: </strong>The clinical features of patients with diagnosed cirrhosis or chronic liver disease who underwent EUS-PPG measurement at a single center were retrospectively analyzed. The correlations between the clinical features of portal hypertension and the EUS-PPG measurements were analyzed, and then receiver operating characteristic curves were used to evaluate the ability of the EUS-PPG measurements to evaluate disease severity.</p><p><strong>Results: </strong>A total of 197 patients were included in this study. The EUS-PPG measurements varied significantly among patients categorized by gastroesophageal varices, red signs, variceal bleeding, ascites, hepatic encephalopathy, thrombocytopenia, hypoproteinemia, prothrombin time, international normalized ratio, or Child-Pugh grade (<i>P</i> < 0.05). The areas under the receiver operating characteristic curves for gastroesophageal varices, decompensated cirrhosis, ascites, and recent variceal bleeding were 0.919, 0.847, 0.813, and 0.804, respectively (<i>P</i> < 0.001). Furthermore, the optimal EUS-PPG cutoff values for gastroesophageal varices, decompensated cirrhosis, ascites, and recent variceal bleeding were 11.5 mm Hg (sensitivity = 80.3%, specificity = 89.5%), 12.75 mm Hg (sensitivity = 77.8%, specificity = 76.7%), 15.75 mm Hg (sensitivity = 66.7%, specificity = 83.1%), and 16.75 mm Hg (sensitivity = 76.2%, specificity = 70.1%), respectively.</p><p><strong>Conclusions: </strong>EUS-PPG measurement seems to be an effective technique for assessing disease severity and risk of variceal bleeding in patients with diagnosed cirrhosis or chronic liver disease.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 2","pages":"65-72"},"PeriodicalIF":4.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093237","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}