Seyfettin Koklu MD , Omer Basar MD , William R. Brugge MD
{"title":"Endoscopic ultrasound guided tumor directed therapy and cyst ablation","authors":"Seyfettin Koklu MD , Omer Basar MD , William R. Brugge MD","doi":"10.1016/j.tgie.2017.10.003","DOIUrl":"10.1016/j.tgie.2017.10.003","url":null,"abstract":"<div><p><span>Endoscopic ultrasonography<span><span> (EUS) has become an interventional procedure for the diagnosis and treatment of various gastrointestinal and </span>pancreatic tumors<span><span><span>. Because of the unique anatomical location of the pancreas, EUS-guided therapies offer substantial promise for the delivery of targeted treatments. This article reviews the recent EUS-guided various therapeutic methods for </span>pancreatic cyst and </span>tumor ablation, especially focusing on </span></span></span>cystic neoplasms.</p></div>","PeriodicalId":43887,"journal":{"name":"Techniques in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tgie.2017.10.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41780318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Endoscopic ultrasound gallbladder drainage: Patient selection, preparation, and performance","authors":"A.J. Small MD, S. Irani MBBS","doi":"10.1016/j.tgie.2017.10.002","DOIUrl":"10.1016/j.tgie.2017.10.002","url":null,"abstract":"<div><p>Acute cholecystitis<span><span> is a common cause of hospital admissions and can result in critically ill patients. For those patients not amenable to cholecystectomy, endoscopic drainage via transpapillary </span>cystic duct<span> stenting or transmural drainage offers a temporizing method for urgent gallbladder decompression. Endoscopic ultrasonography (EUS) and the development of novel lumen apposing metal stents can allow for more permanent drainage with comparable outcomes to percutaneous transhepatic catheters. The merits of this approach including the technical and clinical advantages of EUS-guided drainage are discussed further in this review article.</span></span></p></div>","PeriodicalId":43887,"journal":{"name":"Techniques in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tgie.2017.10.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44823983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Endoscopic ultrasound access, therapy, and treatment of gastrointestinal bleeding","authors":"Larissa L. Fujii-Lau MD , Michael J. Levy MD","doi":"10.1016/j.tgie.2017.10.008","DOIUrl":"10.1016/j.tgie.2017.10.008","url":null,"abstract":"<div><p><span><span><span>The first line of therapy for gastrointestinal bleeding is endoscopic </span>treatment. However, there is a subset of patients in whom standard endoscopic </span>hemostatic treatment fails or is considered unsuitable. Historically, these patients underwent surgical or interventional radiologic procedures to manage the refractory </span>bleed<span>. Endoscopic ultrasound has recently been used to help detect and offer alternative approaches to treatment and potentially improve patient outcome for these difficult-to-treat lesions. This article serves as a review of the novel endoscopic ultrasound techniques used to treat gastrointestinal bleeding.</span></p></div>","PeriodicalId":43887,"journal":{"name":"Techniques in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tgie.2017.10.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46760707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Endoscopic ultrasound–guided biliary and pancreatic duct access and intervention","authors":"Patrick Pfau MD","doi":"10.1016/j.tgie.2017.11.001","DOIUrl":"10.1016/j.tgie.2017.11.001","url":null,"abstract":"<div><p><span>Endoscopic ultrasound (EUS)–guided access to the biliary tree and </span>pancreatic duct with concomitant therapeutic drainage of the ducts via the EUS scope is an evolving technology but being increasingly used by endosonographers. This article will explain the indications and techniques of how the procedure is performed in both the bile and pancreatic duct with a description of the equipment used. Finally, the technical and clinical success of EUS-guided ductal therapy and complications will be reviewed.</p></div>","PeriodicalId":43887,"journal":{"name":"Techniques in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tgie.2017.11.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44717090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Advances in endoscopic ultrasound-guided tissue acquisition","authors":"Silvia Carrara MD , Francesco Auriemma MD , Shyam Varadarajulu MD","doi":"10.1016/j.tgie.2017.10.006","DOIUrl":"10.1016/j.tgie.2017.10.006","url":null,"abstract":"<div><p><span>Endoscopic ultrasound-guided fine-needle aspiration has evolved to become an indispensable tool for tissue acquisition in patients with </span>gastrointestinal tumors<span><span>. The technique is useful for sampling of both luminal and extraluminal lesions adjacent to the gastrointestinal tract. A major limitation however has been the inability to procure tissue for histologic analysis. Recently, </span>core biopsy needles<span><span> have been developed to procure histology-grade material that facilitates both a reliable diagnosis and the ability to conduct molecular profiling for deliverance of personalized </span>anticancer therapy. This review provides a perspective on technical issues that are key for best practices in endoscopic ultrasound-guided tissue acquisition.</span></span></p></div>","PeriodicalId":43887,"journal":{"name":"Techniques in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tgie.2017.10.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47564526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abdul El Chafic MD, Ricardo V. Romero MD, Janak N. Shah MD
{"title":"Interventional endoscopic ultrasound and advanced endoscopic retrograde cholangiopancreatography access techniques","authors":"Abdul El Chafic MD, Ricardo V. Romero MD, Janak N. Shah MD","doi":"10.1016/j.tgie.2017.08.004","DOIUrl":"10.1016/j.tgie.2017.08.004","url":null,"abstract":"<div><p><span>Advanced endoscopic retrograde cholangiopancreatography (ERCP) ductal access techniques require a higher level of skill compared to standard ERCP access maneuvers. These techniques are used in cases of standard ERCP access failures and include dual-wire techniques and precut </span>papillotomy<span>. Interventional endoscopic ultrasound (EUS) procedures requiring a higher level of technical skill as compared to more basic EUS procedures (eg, diagnostic EUS and EUS-fine needle aspiration) include EUS-guided drainage of pancreatic fluid collections, EUS-guided pancreaticobiliary ductal access and drainage, and EUS-guided vascular interventions. In this article, we review techniques and outcomes of advanced ERCP access techniques and of interventional EUS procedures. Issues related to training in these techniques, assessing competency in these procedures, and incorporating these highly complex and higher-risk procedures into endoscopic practice are also discussed.</span></p></div>","PeriodicalId":43887,"journal":{"name":"Techniques in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tgie.2017.08.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49638319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Training pathways and competency assessment in peroral endoscopic myotomy (POEM)","authors":"Chetan Mittal MD, Mihir S. Wagh MD, FACG, FASGE","doi":"10.1016/j.tgie.2017.09.002","DOIUrl":"10.1016/j.tgie.2017.09.002","url":null,"abstract":"<div><p><span>Peroral endoscopic myotomy<span> (POEM) is a minimally invasive natural orifice endoscopic surgical procedure<span> initially developed for treatment of </span></span></span>achalasia<span><span>. Recent studies have shown excellent clinical and safety outcomes in all types of achalasia, and even spastic esophageal disorders. POEM is a complex and technically challenging procedure with risk of potentially serious adverse events. Hence, appropriate training is essential for POEM, even for advanced endoscopists with extensive experience in </span>interventional endoscopy<span>. A few studies have suggested preclinical training using ex vivo and live animal models, with successful transition to human cases but standardized training pathways have not been defined yet. As with other new techniques, there is a learning curve for training in POEM and the number of procedures required to master the technique varies depending on prior endoscopic experience and skill. Procedure time has been shown to improve with case volume, though competence may not be defined only by procedure time and number of procedures performed. In this report, we evaluate training avenues for POEM and suggest competency assessment metrics. Further studies are required to define objective measures of performance and quality metrics for this new endoscopic surgical procedure.</span></span></p></div>","PeriodicalId":43887,"journal":{"name":"Techniques in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tgie.2017.09.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48120704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ralph F. Lee MD, MMEd (Dist), FRCPC , Steven J. Heitman MD, MSc, FRCPC , Michael J. Bourke MBBS, FRACP
{"title":"Training and competency in endoscopic mucosal resection","authors":"Ralph F. Lee MD, MMEd (Dist), FRCPC , Steven J. Heitman MD, MSc, FRCPC , Michael J. Bourke MBBS, FRACP","doi":"10.1016/j.tgie.2017.06.002","DOIUrl":"10.1016/j.tgie.2017.06.002","url":null,"abstract":"<div><p><span>Endoscopic mucosal resection (EMR) should be the preferred method of removal for colonic laterally spreading lesions ≥2</span> <span>cm in size since it is safer, more efficient, and more cost-effective than endoscopic submucosal dissection or surgery. Although competent endoscopists should be comfortable in removing colonic lesions up to 2</span> <!-->cm in size, removal of larger laterally spreading lesions by modern EMR requires advanced skills and meticulous execution of systematic technique to minimize incomplete resection and subsequent interval cancer. Determinations of competency in EMR are important to minimize patient risks and maximize patient outcomes. Assessments of competency may include procedural volumes, direct observational tools, simulators, and other metrics. Advanced training in EMR should be systematic, competency-based; learner- and patient-centered; and must include continual assessment, feedback, reflection, analysis ,and application of identified strategies for improvement. Two models for EMR training, in both the postgraduate and continuing education settings, are proposed along with resources for learning.</p></div>","PeriodicalId":43887,"journal":{"name":"Techniques in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tgie.2017.06.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45019994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pichamol Jirapinyo MD , Christopher C. Thompson MD, MSc
{"title":"Training in bariatric endoscopy","authors":"Pichamol Jirapinyo MD , Christopher C. Thompson MD, MSc","doi":"10.1016/j.tgie.2017.07.003","DOIUrl":"10.1016/j.tgie.2017.07.003","url":null,"abstract":"<div><p><span>Bariatric </span>endoscopy<span><span> has emerged as an alternative treatment modality for obesity and its related comorbidities. The field includes a wide range of procedures from endoscopic treatment for complications of </span>bariatric surgery to performing primary endoscopic procedures for weight loss. Additionally, knowledge of adjunctive lifestyle therapy and pharmacotherapy are also critical to ensuring successful outcomes. This article reviews specific goals, resources, and specific steps for acquisition of specific cognitive and technical skills in bariatric endoscopic procedures.</span></p></div>","PeriodicalId":43887,"journal":{"name":"Techniques in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tgie.2017.07.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45022165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}