Endoscopic Ultrasound最新文献

{"title":"EUS-Guided jejunojejunostomy using a novel dilator for malignant afferent loop obstruction (with video).","authors":"Takeshi Ogura, Kimi Bessho, Yuki Uba, Mitsuki Tomita, Hiroki Nishikawa","doi":"10.1097/eus.0000000000000012","DOIUrl":"10.1097/eus.0000000000000012","url":null,"abstract":"Malignant afferent loop obstruction (MALO) can cause cholangitis or pancreatitis due to blind loop dilatation. Malignant afferent loop obstruction is traditionally treated by surgery, percutaneous drainage, or self-expandable metal stent (SEMS) deployment under enteroscopic guidance. EUS–guided drainage has recently been attempted forMALOusing a lumen-apposingmetal stent (LAMS). Although a LAMS has clinical impact, the diameter of the target lesionmust be large enough to enable deployment of the distal flange of the LAMS. In contrast, conventional SEMS is easily deployed but requires intestinal wall dilatation before insertion of the stent delivery system. If force is used while attempting EUS-guided drainage for MALO, the afferent loop can be pushed away from the echoendoscope, after which it may be difficult to insert the device. A novel drill dilator has recently become available in Japan (Tornus ES; Asahi Intecc, Aichi, Japan) [Figure 1A]. Using this device, the tract is dilated using a clockwise rotationwithout needing","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"12 4","pages":"384-385"},"PeriodicalIF":4.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a7/c2/eusj-12-384.PMC10547239.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41106216","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":"Complete duodenal obstruction and EUS-guided gastroenterostomy: What to do? (with video).","authors":"Maria Puigcerver-Mas, Dani Luna-Rodriguez, Albert Garcia-Sumalla, Sergi Quintana-Carbo, Sandra Maisterra, Joan B Gornals","doi":"10.1097/eus.0000000000000019","DOIUrl":"10.1097/eus.0000000000000019","url":null,"abstract":"Gastroenterostomy using a lumen-apposing metal stent (LAMS) is an effective procedure to solve gastric outlet obstruction, but usually, an oroenteral catheter is necessary for filling the small bowel. [1] What to do in cases of complete obstruction when it is not possible even to advance a guidewire through? The academic purpose of this work was to expose a useful approach that may be considered in this scenario. A 64-year-old woman was referred for a complete duodenal obstruction due to pancreatic adenocarcinoma: first, EUS – guided identification of the collapsed small bowel at the Treitz area, and second, EUS-guided puncture using a 22G needle (without stylet and flushed with saline to avoid air injection), filling contrast and saline into the lumen bowel. A submucosal injection of the enteral wall can be recognized as easy to perform and can help to access nicely the enteral lumen, without doubts and fluoroscopy assistance [","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"12 4","pages":"388-389"},"PeriodicalIF":4.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b3/8d/eusj-12-388.PMC10547241.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41120198","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 therapies for primary and secondary prophylaxis in gastric varices-An updated systematic review and meta-analysis.","authors":"Saurabh Chandan,&nbsp;Andrew Khoi Nguyen,&nbsp;Babu P Mohan,&nbsp;Smit Deliwala,&nbsp;Daryl Ramai,&nbsp;Lena L Kassab,&nbsp;Arunkumar Muthusamy,&nbsp;Antonio Facciorusso,&nbsp;Faisal Kamal,&nbsp;Mohammad Bilal,&nbsp;Jayanta Samanta,&nbsp;Douglas G Adler","doi":"10.1097/eus.0000000000000017","DOIUrl":"10.1097/eus.0000000000000017","url":null,"abstract":"<p><strong>Background and objectives: </strong>Gastric varices (GVs) are associated with a higher risk of uncontrolled bleeding and death when compared with esophageal varices. While endoscopic glue injection therapy has been traditionally used for secondary prophylaxis in GV, data regarding primary prophylaxis continue to emerge. Recently, EUS-guided therapies have been used in GV bleeding.</p><p><strong>Methods: </strong>We conducted a comprehensive search of several major databases from inception to June 2022. Our primary goals were to estimate the pooled rates of treatment efficacy, GV obliteration, GV recurrence, and rebleeding with EUS-guided therapy in primary and secondary prophylaxis. Overall adverse events and technical failures were assessed. Random-effects model was used for our meta-analysis, and heterogeneity was assessed using the <i>I</i>² % statistics.</p><p><strong>Results: </strong>Eighteen studies with 604 patients were included. In primary prophylaxis, pooled rate of GV obliteration was 90.2% (confidence interval [CI], 81.1-95.2; <i>I</i>² = 0). With combination EUS-glue and coil therapy, the rate was 95.4% (CI, 86.7%-98.5%; <i>I</i>² = 0). Pooled rate of posttherapy GV bleeding was 4.9% (CI, 1.8%-12.4%; <i>I</i>² = 0). In secondary prophylaxis, pooled rate of treatment efficacy was 91.9% (CI, 86.8%-95.2%; <i>I</i>² = 12). With EUS-glue, EUS-coil, and combination EUS-glue and coil, the rates were 94.3% (CI, 88.9%-97.1%; <i>I</i>² = 0), 95.5% (CI, 80.3%-99.1%; <i>I</i>² = 0), and 88.7% (CI, 76%-95.1%; <i>I</i>² = 14), respectively. Pooled rate of GV obliteration was 83.6% (CI, 71.5%-91.2%; <i>I</i>² = 74). With EUS-glue, EUS-coil, and combination EUS-glue and coil, the rates were 84.6% (CI, 75.9%-90.6%; <i>I</i>² = 31), 92.3% (CI, 81.1%-97.1%; <i>I</i>² = 0), and 84.5% (CI, 50.8%-96.7%; <i>I</i>² = 75), respectively. Pooled rates of GV rebleeding and recurrence were 18.1% (CI, 13.1%-24.3%; <i>I</i>² = 16) and 20.6% (CI, 9.3%-39.5%; <i>I</i>² = 66), respectively.</p><p><strong>Conclusion: </strong>Our analysis shows that EUS-guided therapy for GVs is technically feasible and clinically successful in both primary and secondary prophylaxis of GV.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"12 4","pages":"351-361"},"PeriodicalIF":4.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/22/9f/eusj-12-351.PMC10547242.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41135566","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":"Identification of sentinel lymph nodes in esophageal cancer patients using contrast-enhanced EUS with peritumoral injections.","authors":"Ji-Bin Liu,&nbsp;Priscilla Machado,&nbsp;John R Eisenbrey,&nbsp;Sriharsha Gummadi,&nbsp;Flemming Forsberg,&nbsp;Corinne E Wessner,&nbsp;Anand Raman Kumar,&nbsp;Austin Chiang,&nbsp;Anthony Infantolino,&nbsp;Alexander Schlachterman,&nbsp;Thomas Kowalski,&nbsp;Robert Coben,&nbsp;David Loren","doi":"10.1097/eus.0000000000000001","DOIUrl":"10.1097/eus.0000000000000001","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this pilot study was to compare the performance of contrast-enhanced EUS (CE-EUS)-guided fine-needle aspiration (FNA) with EUS-FNA for lymph node (LN) staging in esophageal cancer.</p><p><strong>Methods: </strong>Thirty-seven subjects with esophageal cancer undergoing EUS staging were enrolled, and 30 completed this institutional review board-approved study. A Prosound F75 US system (Hitachi Medical Systems, Tokyo, Japan) with harmonic contrast imaging software and GF-UCT180 curvilinear endoscope (Olympus, Tokyo, Japan) was utilized. All LNs identified by standard EUS were first noted. Sonazoid (dose: 1 mL; GE Healthcare, Oslo, Norway) was administered peritumorally, and all enhanced LNs were recorded. Fine-needle aspiration was performed on LNs considered suspicious by EUS alone, as well as LNs enhanced on CE-EUS. Performance of each modality was compared using FNA cytology as reference standard.</p><p><strong>Results: </strong>A total of 132 LNs were detected with EUS, of which 59 showed enhancement on CE-EUS. Fifty-three LNs underwent FNA, and 22 LNs were determined to be malignant. Among the latter, 10 were considered suspicious by EUS, whereas the other 12 LNs underwent FNA only because of CE-EUS enhancement. Contrast-enhanced EUS showed enhancement in 19 of the 22 malignant LNs. The rate of metastatic node identification from EUS was 45% (10/22), and it was 86% (19/22; <i>P</i> = 0.008) for CE-EUS. Eight subjects (8/30 [27% of study total]) had nodal status upgraded by the addition of CE-EUS, which influenced LN staging and clinical management.</p><p><strong>Conclusions: </strong>Fine-needle aspiration of LNs identified by CE-EUS may increase metastasis positive rate by ruling out LNs not associated with the tumor drainage pattern. In addition, CE-EUS seems to identify more metastatic LNs that would not be biopsied under the standard EUS criteria.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"12 4","pages":"362-368"},"PeriodicalIF":4.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a4/95/eusj-12-362.PMC10547247.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41108400","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 features of hepatic visceral larva migrans (with video).","authors":"Abhirup Chatterjee,&nbsp;Anurag Sachan,&nbsp;Suvradeep Mitra,&nbsp;Nalini Gupta,&nbsp;Pankaj Kumar,&nbsp;Vaneet Jearth,&nbsp;Rajesh Gupta,&nbsp;Surinder Singh Rana","doi":"10.1097/eus.0000000000000023","DOIUrl":"10.1097/eus.0000000000000023","url":null,"abstract":"A 36-year-old man presented with right upper abdominal pain of 6 months in duration. It was associated with loss of weight and appetite. He had a poultry farm and had exposure to dogs. Investigations revealed eosinophilia with an absolute eosinophil count of 4390 cells/mm 3 . Contrast-enhanced computed tomographic scan of the abdomen revealed multiple ill-defined hypodense lesions in both the lobes of the liver [Figure 1]. Viral and tumor markers were negative. Ultrasound-guided fine needle aspiration from the liver lesion done elsewhere was inconclusive, and the patient was referred to us for EUS.","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"12 4","pages":"390-392"},"PeriodicalIF":4.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6f/02/eusj-12-390.PMC10547245.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41108160","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-derived maximum tumor thickness and tumor shrinkage rate as independent prognostic factors in locally advanced esophageal squamous cell carcinoma after neoadjuvant chemoradiotherapy.","authors":"Xue Chen,&nbsp;Xi Chen,&nbsp;Yu Bao,&nbsp;Wei Zhang,&nbsp;Li Jiang,&nbsp;Jie Zhu,&nbsp;Yi Wang,&nbsp;Lei Wu,&nbsp;Gang Wan,&nbsp;Lin Peng,&nbsp;Yongtao Han,&nbsp;Xuefeng Leng,&nbsp;Qifeng Wang,&nbsp;Rui Zhao","doi":"10.1097/eus.0000000000000008","DOIUrl":"10.1097/eus.0000000000000008","url":null,"abstract":"<p><strong>Background and objectives: </strong>EUS-derived maximum tumor thickness (MTT) pre- and post-neoadjuvant chemoradiotherapy (NCRT) for locally advanced esophageal squamous cell carcinoma (LA-ESCC) indicates treatment response. However, the accuracy of predicting long-term survival remains uncertain. This study aimed to investigate the association between EUS-derived MTT pre- and post-NCRT and tumor shrinkage rate as well as long-term survival in patients with LA-ESCC receiving NCRT.</p><p><strong>Methods: </strong>We retrospectively enrolled patients with LA-ESCC who underwent EUS examination from 2017 to 2021. Tumor shrinkage rate was the ratio of the difference between pre- and post-MTT to pre-MTT. The most fitted cutoff values were determined by the receiver operating characteristic curve. Univariate and multivariate Cox regression analyses and Kaplan-Meier curves were used to calculate overall survival (OS) and progression-free survival. Data from another center were also used for external validation testing.</p><p><strong>Results: </strong>Two hundred thirty patients were enrolled. Of the patients, 178 completed the first EUS pre-NCRT and obtained pre-MTT, 200 completed the reexamined EUS post-NCRT and obtained post-MTT, and 148 completed both EUS and achieved tumor shrinkage. For all the patients, the 1- and 3-year OS rates were 93.9% and 67.9%, and progression-free survival rates were 77.7% and 54.1%, respectively. The median follow-up period was 30.6 months. Thinner post-MTT (≤8.8 mm) and EUS responder (tumor shrinkage rate ≥52%) were independently associated with better OS.</p><p><strong>Conclusions: </strong>EUS-derived MTT and tumor shrinkage post-NCRT are independent prognostic factors for long-term survival and may be an alternative method for evaluating tumor response in patients with LA-ESCC after NCRT.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"12 4","pages":"369-376"},"PeriodicalIF":4.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/31/7e/eusj-12-369.PMC10547243.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41108161","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 level of glucose in pancreatic cyst fluid is more accurate than carcinoembryonic antigen to identify mucinous tumors: A French multicenter study.","authors":"Nicolas Williet,&nbsp;Fabrice Caillol,&nbsp;David Karsenti,&nbsp;Einas Abou-Ali,&nbsp;Marine Camus,&nbsp;Arthur Belle,&nbsp;Ulriikka Chaput,&nbsp;Jonathan Levy,&nbsp;Jean-Philippe Ratone,&nbsp;Quentin Tournier,&nbsp;Rémi Grange,&nbsp;Bertrand Le Roy,&nbsp;Aymeric Becq,&nbsp;Jean-Marc Phelip","doi":"10.1097/eus.0000000000000024","DOIUrl":"10.1097/eus.0000000000000024","url":null,"abstract":"<p><strong>Background and objectives: </strong>Pancreatic cyst fluid level of glucose is a promising marker to identify mucinous from nonmucinous tumors, but the glucose assay has not yet been recommended. The objective of this study is to compare the diagnostic performances of pancreatic cyst fluid level of glucose and carcinoembryonic antigen (CEA).</p><p><strong>Methods: </strong>In this French multicenter study, data of consecutive patients who underwent fine-needle aspiration of pancreatic cyst with intracyst glucose assay between 2018 and 2022 were retrospectively reviewed. The area under the receiver operating characteristic curve (AUROC) of glucose and corresponding sensitivity (Se), specificity (Sp), accuracy (Acc), positive predictive value (PPV), and negative predictive value (NPV) were calculated and compared with those of CEA. The best threshold of glucose was identified using the Youden index.</p><p><strong>Results: </strong>Of the 121 patients identified, 81 had a definitive diagnosis (46 mucinous, 35 nonmucinous tumors) and were included for analysis. An intracystic glucose level <41.8 mg/dL allowed identification of mucinous tumors with better diagnostic performances (AUROC, 93.6%; 95% confidence interval, 87.2%-100%; Se, 95.3%; Sp, 91.2%; Acc, 93.5%; PPV, 93.2%; NPV, 93.9%) compared with CEA level >192 ng/mL (AUROC, 81.2%; 95% confidence interval, 71.3%-91.1%; Se, 41.7%; Sp, 96.9%; Acc, 67.6%; PPV, 93.8%; NPV, 59.6%) (<i>P</i> = 0.035). Combining values of glucose and CEA did not offer additional benefit in terms of diagnosis.</p><p><strong>Conclusion: </strong>Our results confirm previously published data and support the use of pancreatic cyst fluid glucose for the identification of mucinous tumors when the definitive diagnosis remains uncertain.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"12 4","pages":"377-381"},"PeriodicalIF":4.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4f/03/eusj-12-377.PMC10547248.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41108162","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> percutaneous liver biopsy: A prospective randomized clinical trial.","authors":"Ahmad H Ali,&nbsp;Naren S Nallapeta,&nbsp;Muhammad N Yousaf,&nbsp;Gregory F Petroski,&nbsp;Neal Sharma,&nbsp;Deepthi S Rao,&nbsp;Feng Yin,&nbsp;Ryan M Davis,&nbsp;Ambarish Bhat,&nbsp;Ahmed I A Swi,&nbsp;Alhareth Al-Juboori,&nbsp;Jamal A Ibdah,&nbsp;Ghassan M Hammoud","doi":"10.1097/eus.0000000000000010","DOIUrl":"10.1097/eus.0000000000000010","url":null,"abstract":"<p><strong>Background and objectives: </strong>Prospective studies comparing EUS-guided liver biopsy (EUS-LB) to percutaneous LB (PC-LB) are scarce. We compared the efficacy and safety of EUS-LB with those of PC-LB in a prospective randomized clinical trial.</p><p><strong>Methods: </strong>Between 2020 and 2021, patients were enrolled and randomized (1:1 ratio). The primary outcome was defined as the proportion of patients with ≥11 complete portal tracts (CPTs). The sample size (n = 80) was calculated based on the assumption that 60% of those in the EUS-LB and 90% of those in the PC-LB group will have LB with ≥11 CPTs. The secondary outcomes included proportion of patients in whom a diagnosis was established, number of CPTs, pain severity (Numeric Rating Scale-Pain Intensity), duration of hospital stay, and adverse events.</p><p><strong>Results: </strong>Eighty patients were enrolled (median age, 53 years); 67.5% were female. Sixty percent of those in the EUS-LB and 75.0% of those in the PC-LB group met the primary outcome (<i>P</i> = 0.232). The median number of CPTs was higher in the PC-LB (17 vs 13; <i>P</i> = 0.031). The proportion of patients in whom a diagnosis was established was similar between the groups (92.5% [EUS-LB] vs 95.0% [PC-LB]; <i>P</i> = 1.0). Patients in the EUS-LB group had less pain severity (median Numeric Rating Scale-Pain Intensity, 2.0 vs 3.0; <i>P</i> = 0.003) and shorter hospital stay (2.0 vs 4.0 hours; <i>P</i> < 0.0001) compared with the PC-LB group. No patient experienced a serious adverse event.</p><p><strong>Conclusions: </strong>EUS-guided liver biopsy was safe, effective, better tolerated, and associated with a shorter hospital stay.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"12 3","pages":"334-341"},"PeriodicalIF":4.5,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/17/10/eusj-12-334.PMC10437149.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10225151","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":"Safety and clinical efficacy of EUS-guided pelvic abscess drainage.","authors":"Maher Al Khaldi,&nbsp;Alexander Ponomarev,&nbsp;Carole Richard,&nbsp;François Dagbert,&nbsp;Herawaty Sebajang,&nbsp;Frank Schwenter,&nbsp;Ramses Wassef,&nbsp;Éric De Broux,&nbsp;Richard Ratelle,&nbsp;Sarto C Paquin,&nbsp;Anand V Sahai,&nbsp;Rasmy Loungnarath","doi":"10.1097/eus.0000000000000020","DOIUrl":"10.1097/eus.0000000000000020","url":null,"abstract":"<p><strong>Background and objectives: </strong>EUS is a potential alternative for the drainage of abscesses. The aim of this study was to determine if EUS-guided pelvic abscess drainage is technically feasible, safe, and a valid option for abscess resolution.</p><p><strong>Methods: </strong>We conducted a retrospective review from 2002 to 2020 at a single quaternary institution. EUS-guided pelvic abscess drainage via the transrectal route was performed in all patients with or without drain/stent placement. Technical and clinical success of EUS-guided pelvic abscess drainage was analyzed. Descriptive analyses and Fisher exact test were performed.</p><p><strong>Results: </strong>Sixty consecutive patients were included in the study (53.5% male; mean age, 53.8 ± 17.9 years). Pelvic abscesses occurred mainly postoperatively (33 cases; 60.0%) and from complicated diverticulitis (14 cases; 23.3%). Mean diameter was 6.5 ± 2.4 cm (80% unilocular). Drainage was performed with EUS-guided stent placement (double-pigtail plastic or lumen-apposing metal) in 74.5% of cases and with aspiration alone for the remainder. Technical success occurred in 58 cases (97%). Of those with long-term follow-up after EUS-guided pelvic abscess drainage (<i>n</i> = 55; 91.7%), complete abscess resolution occurred in 72.7% of all cases. Recurrence occurred in 8 cases (14.5%) and persisted in 7 patients (12.5%), 7 of which were successfully retreated with EUS-guided pelvic abscess drainage. Accounting for these successful reinterventions, the overall rate of abscess resolution was 85.5%. Abscess resolution rate improved with drain placement (83%). Accounting for 7 repeat EUS-guided pelvic abscess drainages, overall abscess resolution improved. Two deaths occurred (3.4%) because of sepsis from failed source control in patients who had previously failed medical, radiological, and surgical treatment.</p><p><strong>Conclusions: </strong>EUS-guided pelvic abscess drainage is technically feasible, safe, and an effective alternative to radiological or open surgical drainage. It also offers favorable clinical outcomes in different clinical situations.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"12 3","pages":"326-333"},"PeriodicalIF":4.5,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ad/17/eusj-12-326.PMC10437202.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10225149","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 gallbladder drainage using a 22-gauge needle and 0.018-inch guidewire: A rescue technique in a challenging situation to puncture (with video).","authors":"Kazuya Koizumi,&nbsp;Sakue Masuda,&nbsp;Ryuhei Jinushi,&nbsp;Kento Shionoya","doi":"10.1097/eus.0000000000000005","DOIUrl":"10.1097/eus.0000000000000005","url":null,"abstract":"Copyright © 2023 The Author(s). Published by Wolters Kluwer on behalf of Scholar Media Publishing. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-ShareAlike License 4.0 (CC BY-NC-SA) which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"12 3","pages":"342-344"},"PeriodicalIF":4.5,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6d/22/eusj-12-342.PMC10437205.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10223031","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}