Therapeutic endosonography – current position

Česká verzia

Authors: M. Kliment
Authors place of work: Gastroenterologie und Hepatologie, Klinik für Innere Medizin, Vivantes Klinikum Spandau, Berlin, Německo
Published in the journal: Gastroent Hepatol 2016; 70(3): 208-216
Category: Digestive Endoscopy: Review Article
doi: https://doi.org/10.14735/amgh2016208

Summary

Technological advances in echoendoscopes and their accessories has contributed to the continuing employment of therapeutic endosonography (EUS). EUS-guided therapy can be divided into EUS-guided drainage/anastomosis therapy and EUS-guided injection therapy. EUS-guided transmural drainage of pancreatic fluid collections and EUS-guided coeliac plexus neurolysis are now well established therapeutic techniques. Another technically and clinically effective procedure is EUS-guided drainage of abdominal (non-pancreatic) and pelvic collections adjacent to the gastric, duodenal and rectal wall (periproctal, hepatal, and subphrenic abscesses), although the data regarding these procedures are limited. EUS-guided biliary drainage/anastomosis (EUS-hepaticogastrostomy and EUS-choledocholduodenostomy) in the hands of an experienced interventional endoscopist with the support of an interventional radiologist and a surgeon is an alternative to percutaneous transhepatic biliary drainage. EUS-guided pancreaticogastrostomy is more technically challenging and has higher complication rates. In the case of conventional bile duct or pancreatic duct cannulation failure, the EUS-guided rendezvous technique is an option for achieving successful cannulation. EUS-guided antitumorous therapy including EUS-alcohol ablation of pancreatic cystic neoplasia is currently the object of ongoing clinical studies. Potential uses of therapeutic EUS in the future could be EUS-guided vascular therapy and EUS-guided gastroenteroanastomosis. The aim of this article is to provide up-to-date information on the current position of therapeutic EUS in clinical practice using evidence-based data in the literature.

Key words:
endosonography – endoscopic ultrasound-guided therapy – endosopic pseudocystogastrostomy

The author declares he has no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted:
12. 4. 2016

Accepted:
20. 5. 2016

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