Endoscopic Ultrasound最新文献

{"title":"Single-session multi-segment EUS-guided biliary drainage in surgically altered anatomy: Three-route drainage for high-grade hilar obstruction (with video).","authors":"Masaki Miyazawa, Shotaro Kawase, Hajime Takatori","doi":"10.1097/eus.0000000000000192","DOIUrl":"10.1097/eus.0000000000000192","url":null,"abstract":"","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"15 3","pages":"244-246"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583657","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 treatment of complex malignant bowel obstruction with EUS-guided enterocolostomy (with video).","authors":"Sa Fang, Xuegang Guo, Mengmeng Zhang, Jie Hao, Yupeng Shi","doi":"10.1097/eus.0000000000000186","DOIUrl":"10.1097/eus.0000000000000186","url":null,"abstract":"","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"15 3","pages":"237-240"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583648","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 <i>versus</i> direct endoscopic cyanoacrylate injection for variceal eradication: A systematic review and meta-analysis of randomized controlled trials.","authors":"Mohamed Abuelazm, Abdelrahman Awad, Omar Elkoumi, Mohamed S Elgendy, Ahmed A Ibrahim, Mohamed Saad Rakab, Douglas G Adler","doi":"10.1097/eus.0000000000000207","DOIUrl":"10.1097/eus.0000000000000207","url":null,"abstract":"<p><p>While direct endoscopic cyanoacrylate injection (DEI-CYA) is the standard hemostatic therapy, it is associated with risks of ectopic embolization and ulceration. EUS-guided injection (EUS-CYA) allows for precise targeting of feeder vessels, potentially improving outcomes. A comprehensive search was conducted across PubMed, Web of Science, CENTRAL, and Scopus for RCTs up to January 2026. Primary outcomes included early and late rebleeding rates and variceal eradication. Risk ratios (RRs) and standardized mean differences (SMD) were pooled using a random-effects model. Five RCTs involving 440 patients were included. EUS-CYA was associated with a significant reduction in late rebleeding compared with DEI-CYA (RR: 0.40; 95% confidence intervals [CI]: 0.27-0.60; <i>P</i> < 0.001). However, there was no significant difference in early rebleeding (<i>P</i> = 0.53) or overall variceal eradication rates (RR: 1.13; 95% CI: 0.97-1.31; <i>P</i> = 0.11). Regarding safety, EUS-CYA significantly reduced the risk of postinjection ulcers (RR: 0.32; 95% CI: 0.11-0.93; <i>P</i> = 0.04), while rates of ectopic embolism (<i>P</i> = 0.75) and mortality (<i>P</i> = 0.65) were comparable. Procedurally, EUS-CYA was more efficient, requiring significantly less cyanoacrylate (SMD: -0.35; 95% CI: -0.61 to -0.09; <i>P</i> = 0.01) and fewer sessions for eradication (SMD: -1.28; 95% CI: -2.50 to -0.05; <i>P</i> = 0.04). Current evidence suggests that EUS-CYA likely reduces the risk of late rebleeding compared with DEI-CYA. While the data indicate potential benefits regarding procedural efficiency (reduced cyanoacrylate volume and fewer sessions) and a lower incidence of postinjection ulcers, the certainty of evidence for these outcomes remains very low.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"15 3","pages":"169-180"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583557","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 gastrojejunostomy to treat afferent loop obstruction after distal gastrectomy with Roux-en-Y anastomosis (with video).","authors":"Sen Shi, Jiarun Jiang, Yan Cheng, Xiaojia Chen, Jun Fang, Jun Lin, Jian Shang","doi":"10.1097/eus.0000000000000178","DOIUrl":"10.1097/eus.0000000000000178","url":null,"abstract":"","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"15 3","pages":"234-236"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583575","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":"Pancreatic steatosis endosonographic criteria: A histology-validated EUS diagnostic study.","authors":"Tanawat Geeratragool, Nonthalee Pausawasdi, Napat Angkathunyakul, Manus Rugivarodom, Phunchai Charatcharoenwitthaya, Kotchakon Maipang, Uayporn Kaosombatwattana, Prawat Kositamongkol, Prawej Mahawithitwong, Chutwichai Tovikkai, Wethit Dumronggittigule, Charnwit Assawasirisin, Pholasith Sangserestid, Kulyada Chuesuay, Napat Limsirorat, Ananya Pongpaibul, Yongyut Sirivatanauksorn","doi":"10.1097/eus.0000000000000176","DOIUrl":"10.1097/eus.0000000000000176","url":null,"abstract":"<p><strong>Background and objectives: </strong>Pancreatic steatosis (PS) is increasingly recognized as a clinically significant condition. Although EUS is commonly used to evaluate PS, existing diagnostic criteria lack histologic validation. This study aimed to establish histology-validated EUS criteria for diagnosing PS.</p><p><strong>Methods: </strong>Patients undergoing EUS before pancreatic surgery were prospectively enrolled. Two experienced endosonographers independently assessed predefined EUS features, with interobserver agreement evaluated. Histologic confirmation of PS was obtained from surgical specimens. Features significantly associated with histologic PS were used to develop the pancreatic steatosis endosonographic criteria (PSEC).</p><p><strong>Results: </strong>Of 132 enrolled patients, 96 completed the study. Histologic PS was confirmed in 27.10% of cases. EUS features independently associated with PS included hyperechoic parenchyma (odds ratio [OR]: 51.96), obscured main pancreatic duct margin (OR: 10.88), obscured \"salt-and-pepper\" appearance (OR: 8.25), and absence of hyperechoic foci or strands (OR: 5.11). Based on these findings, the PSEC were established, consisting of 1 major criterion (hyperechoic parenchyma) and 3 minor criteria (obscured salt-and-pepper appearance, obscured main pancreatic duct margin, and absence of hyperechoic foci or strands). The optimal diagnostic threshold was defined as either 1 major plus 1 minor criterion or 3 minor criteria. This model achieved an area under the receiver operating characteristic curve of 0.84 (95% confidence interval [CI]: 0.8-0.9), sensitivity of 84.60%, specificity of 87.10%, positive predictive value of 71%, and negative predictive value of 93.80%, with substantial interobserver agreement.</p><p><strong>Conclusion: </strong>PSEC represents the first histology-validated EUS criteria for PS, demonstrating robust diagnostic performance and practical applicability in clinical practice.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"15 3","pages":"217-224"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583595","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 transesophageal removal of a chronically retained fish bone complicated by a paraesophageal mediastinal abscess (with video).","authors":"Tengjiao Gao, Haoran Li, Jiangning Gu, Zhuo Yang","doi":"10.1097/eus.0000000000000177","DOIUrl":"10.1097/eus.0000000000000177","url":null,"abstract":"","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"15 3","pages":"241-243"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583560","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":"Comparison of EUS-guided treatment and balloon-enteroscopy-assisted endoscopic retrograde cholangiopancreatography for large bile duct stone removal in patients with surgically altered anatomy: A multicenter study.","authors":"Ryota Sagami, Kiyoyuki Kobayashi, Makoto Hinokuchi, Kosuke Takahashi, Eisuke Ozawa, Takehiko Koga, Yusuke Ishida, Shotaro Kakehashi, Nao Fujimori, Yasuhisa Hiroshima, Issei Kojima, Hideki Mori, Naosuke Kuraoka, Hidefumi Nishikiori, Kazunari Murakami, Kazuhiro Mizukami","doi":"10.1097/eus.0000000000000198","DOIUrl":"10.1097/eus.0000000000000198","url":null,"abstract":"<p><strong>Background and objectives: </strong>Large bile duct stone removal in patients with surgically altered anatomy (SAA) is technically challenging. Although balloon-enteroscopy-assisted endoscopic retrograde cholangiopancreatography (BE-ERCP) has been widely adopted, EUS-guided treatment (EUS-T) may achieve higher stone removal rates owing to improved device accessibility after anastomosis. In this multicenter retrospective study, we aimed to compare the outcomes of EUS-T and BE-ERCP for large bile duct stones in patients with SAA.</p><p><strong>Methods: </strong>Patients with SAA who underwent EUS-T or BE-ERCP for large bile duct stones (≥12 mm) between January 2016 and February 2025 were included. The primary outcome was the complete stone removal rate. Secondary outcomes included the number of sessions, procedure time, and adverse events. Propensity score matching was applied to adjust for baseline differences between groups.</p><p><strong>Results: </strong>In total, 22 EUS-T and 87 BE-ERCP procedures were analyzed. After matching, the complete stone removal rate was significantly higher in the EUS-T group than in the BE-ERCP group (90.5% <i>vs.</i> 61.9%, <i>P</i> = 0.030), despite a greater number of sessions (2.1 <i>vs.</i> 1.2, <i>P</i> < 0.001). Mean procedure times and adverse event rates were comparable. Cumulative success significantly improved up to the third session in EUS-T (first session, 27%; third, 86%).</p><p><strong>Conclusion: </strong>EUS-T achieved a higher complete stone removal rate than BE-ERCP without a significant increase in adverse event rates, and may be a first-line treatment option for large bile duct stones in patients with SAA.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"15 3","pages":"191-201"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583611","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":"Epithelial ovarian carcinoma metastasizing to the pancreas: An uncommon diagnosis with EUS-guided fine-needle biopsy.","authors":"Stefano Rizza, Paola Calamaro, Valentina Tuninetti, Francesco Maria Stalla, Alessandro Lavagna, Marco Daperno","doi":"10.1097/eus.0000000000000202","DOIUrl":"10.1097/eus.0000000000000202","url":null,"abstract":"","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"15 3","pages":"231-233"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583608","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 choledochoduodenostomy as salvage therapy for surgical choledochoduodenostomy dysfunction.","authors":"Péter Lassú, István Szabó, Csaba Lőrinczi, Zsolt Dubóczki, Attila Doros, Richárd Szmola","doi":"10.1097/eus.0000000000000201","DOIUrl":"10.1097/eus.0000000000000201","url":null,"abstract":"","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"15 3","pages":"247-249"},"PeriodicalIF":4.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583570","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":"Nasocystic irrigation reduces suprainfection and stent occlusion after LAMS drainage of walled-off necrosis.","authors":"Huifang Xiong, Sihai Chen, Wenqing Wang, Xu Shu, Zhijian Liu, Lingyu Luo, Liang Xia, Wenhua He, Yang Hu, Xin Huang, Yupeng Lei, Chen Yu, Qian Liao, Nonghua Lu, Yin Zhu","doi":"10.1097/eus.0000000000000180","DOIUrl":"10.1097/eus.0000000000000180","url":null,"abstract":"<p><strong>Background and objectives: </strong>Suprainfection and stent occlusion complicate lumen-apposing metal stent (LAMS) drainage for walled-off necrosis (WON). The aim of this study was to evaluate whether adjunctive nasocystic irrigation improves the clinical efficiency.</p><p><strong>Methods: </strong>Eighty patients with WON underwent endoscopic ultrasonography-guided transgastric LAMS placement and were randomized 1:1 to LAMS alone (<i>n</i> = 40) or LAMS with twice-daily nasocystic saline irrigation (<i>n</i> = 40). Primary endpoint was suprainfection within 7 days. Secondary outcomes included stent occlusion, other adverse events, and clinical outcomes including clinical success rate, debridement frequency, duration of LAMS placement, postoperative hospital stay length, postoperative intensive care unit admission, and surgical intervention.</p><p><strong>Results: </strong>Nasocystic irrigation significantly reduced suprainfection (intention-to-treat: 37.5% <i>vs</i>. 55.0%, <i>P</i> = 0.178; as-treated: 34.2% <i>vs.</i> 57.1%, <i>P</i> = 0.044) and stent occlusion rates (intention-to-treat: 20.0% <i>vs</i>. 45.0%, <i>P</i> = 0.032; as-treated: 18.4% <i>vs</i>. 45.2%, <i>P</i> = 0.020). Fewer bleeding events occurred with irrigation (3 <i>vs</i>. 6 cases), though without a significant difference. Clinical success rate increased with nasocystic irrigation in 5% of patients, clinical outcomes including debridement frequency and postoperative intensive care unit admission showed a decreasing trend.</p><p><strong>Conclusion: </strong>Nasocystic irrigation significantly decreases suprainfection and stent occlusion following LAMS placement for WON, and may be attributable to improve clinical outcomes.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"15 2","pages":"110-118"},"PeriodicalIF":4.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13263086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249812","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}