• Users Online:122
  • Home
  • Print this page
  • Email this page
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login
Export selected to
Endnote
Reference Manager
Procite
Medlars Format
RefWorks Format
BibTex Format
   Table of Contents - Current issue
Coverpage
March-April 2019
Volume 8 | Issue 2
Page Nos. 73-138

Online since Friday, April 12, 2019

Accessed 16,418 times.

PDF access policy
Journal allows immediate open access to content in HTML + PDF
View as eBookView issue as eBook
Access StatisticsIssue statistics
RSS FeedRSS
Hide all abstracts  Show selected abstracts  Export selected to  Add to my list
EDITORIAL  

EUS-guided fine-needle technique-derived cancer organoids: A tailored “Shennong deity” for every patient with cancer p. 73
Fan Yang, He Wang, Xiang Liu, Nan Ge, Jintao Guo, Sheng Wang, Xiaoyu Song, Liu Cao, Siyu Sun
DOI:10.4103/eus.eus_13_19  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
TRAINING COURSE Top

Radial EUS imaging of the liver: A pictorial guide p. 76
Vikram Bhatia, Vinay Dhir
DOI:10.4103/eus.eus_17_19  
Systematic radial EUS imaging can provide a detailed evaluation of most of the liver segments, liver hilum, and hilar and intra-hepatic vascular and ductal anatomy. Innumerable scan planes are possible, and the endosonographers must reference the intra-hepatic vascular structures and ligaments, surface landmarks such as the gallbladder, and adjacent organs such as cardiac chambers and kidneys to define the liver segments. There is no strict demarcation between the adjacent segments, and all estimates are rough approximations. Radial EUS cannot sample detected lesions but can comprehensively evaluate the liver for any pathology. In particular, the superior part of the right anterior sector (S8), S4, and S6 are better seen with the radial than linear EUS probe. Unlike common belief, the liver hilum can also be well evaluated with the radial EUS probe from the mid and upper gastric body, similar to linear probe EUS imaging. Radial EUS imaging of the liver is carried out from three stations: gastroesophageal junction, upper-mid gastric body, and antrum-duodenal bulb. We describe a step-by-step approach to radial EUS description of liver anatomy in this pictorial review.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
REVIEW ARTICLE Top

Lumen apposing metal stents in drainage of pancreatic walled-off necrosis, are they any better than plastic stents? A systematic review and meta-analysis of studies published since the revised Atlanta classification of pancreatic fluid collections p. 82
Babu P Mohan, Mahendran Jayaraj, Ravishankar Asokkumar, Mohammed Shakhatreh, Parul Pahal, Suresh Ponnada, Udayakumar Navaneethan, Douglas G Adler
DOI:10.4103/eus.eus_7_19  
Lumen-apposing metal stents (LAMS) are increasingly being used in the drainage of pancreatic walled-off necrosis (WON). Best choice of stent is subject to argument, and studies are varied in the reported outcomes between LAMS and plastic stents (PS) to this end. We conducted a comprehensive search of multiple electronic databases and conference proceedings including PubMed, EMBASE, and Web of Science databases (earliest inception through July 2018) to identify studies that reported on the use of LAMS and PS in WON drainage. Studies published since the release of the revised Atlanta classification for pancreatic fluid collections (2014 to current) were included in the analysis. The outcomes were to estimate and compare the pooled rates of clinical success, and adverse-events. A total of 9 studies (737 patients) for LAMS and 6 studies (527 patients) for PS were included in the analysis. The pooled rate of clinical-success with LAMS was 88.5% (95% CI 82.5-92.6, I2 = 71.7) and with PS was 88.1% (95% CI 80.5-93.0, I2 = 78.1) and the difference was not statistically significant, P = 0.93. No difference was noted in the pooled rates of all adverse-events, LAMS: 11.2% (6.8-17.9, I2 = 82.0); vs PS: 15.9% (8.4-27.8, I2 = 78.8); P = 0.38. Based on our meta-analysis, LAMS and PS demonstrate equal clinical outcomes and equal adverse-events in the drainage of pancreatic WON.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
ORIGINAL ARTICLES Top

Fluid collection after partial pancreatectomy: EUS drainage and long-term follow-up Highly accessed article p. 91
Fabrice Caillol, Sebastien Godat, Olivier Turrini, Christophe Zemmour, Erwan Bories, Christian Pesenti, Jean Phillippe Ratone, Jacques Ewald, Jean Robert Delpero, Marc Giovannini
DOI:10.4103/eus.eus_112_17  PMID:29600794
Background and Objectives: Postoperative fluid collection due to pancreatic leak is the most frequent complication after pancreatic surgery. EUS-guided drainage of post-pancreatic surgery fluid collection is the gold standard procedure; however, data on outcomes of this procedure are limited. The primary endpoint of our study was relapse over longterm followup, and the secondary endpoint was the efficiency and safety of EUS-guided drainage of post-pancreatic surgery fluid collection. Patients and Methods: This retrospective study was conducted at a single center from December 2008 to April 2016. Global morbidity was defined as the occurrence of an event involving additional endoscopic procedures, hospitalization, or interventional radiologic or surgical procedures. EUS-guided drainage was considered a clinical failure if surgery was required to treat a relapse after stent removal. Results: Fortyone patients were included. The technical success rate was 100%. Drainage was considered a clinical success in 93% (39/41) of cases. Additionally, 19 (46%) complications were identified as global morbidity. The duration between surgery and EUS-guided drainage was not a significantly related factor for morbidity rate (P = 0.8); however, bleeding due to arterial injuries (splenic artery and gastroduodenal artery) from salvage drainage procedures occurred within 25 days following the initial surgery. There was no difference in survival between patients with and without complications. No relapse was reported during the followup (median: 44.75 months; range: 29.24 to 65.74 months). Conclusion: EUSguided drainage for post-pancreatic surgery fluid collection was efficient with no relapse during longterm followup. Morbidity rate was independent of the duration between the initial surgery and EUS-guided drainage; however, bleeding risk was likely more important in cases of early drainage.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

A multicenter evaluation of a new EUS core biopsy needle: Experience in 200 patients Highly accessed article p. 99
Douglas G Adler, V. Raman Muthusamy, Dean S Ehrlich, Gulshan Parasher, Nirav C Thosani, Ann Chen, Jonathan M Buscaglia, Anoop Appannagari, Eduardo Quintero, Harry Aslanian, Linda Jo Taylor, Ali Siddiqui
DOI:10.4103/eus.eus_53_17  PMID:29623911
Background and Objectives: We present a multicenter study of a new endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) needle (Acquire, Boston Scientific, Natick, MA). The aim of the study was to analyze the needle's clinical performance when sampling solid lesions and to assess the safety of this device. Methods: We performed a multicenter retrospective study of patients undergoing EUS-FNB during July 1–November 15, 2016. Results: Two hundred patients (121 males and 79 females) underwent EUS-FNB of solid lesions with the Acquire needle. Lesions included solid pancreatic masses (n = 109), adenopathy (n = 45), submucosal lesions (n = 34), cholangiocarcinoma (n = 8), liver lesions (n = 6), and other (n = 8). Mean lesion size was 30.6 mm (range: 3–100 mm). The mean number of passes per target lesion was 3 (range: 1–7). Rapid onsite cytologic evaluation (ROSE) by a cytologist was performed in all cases. Tissue obtained by EUS-FNB was adequate for evaluation and diagnosis by ROSE in 197/200 cases (98.5%). Data regarding the presence or absence of a core of tissue obtained after EUS-FNB were available in 145/200 procedures. In 131/145 (90%) of cases, a core of tissue was obtained. Thirteen out of 200 patients (6.5%) underwent some form of repeat EUS-based tissue acquisition after EUS-FNB with the Acquire needle. There were no adverse events. Conclusion: Overall, this study showed a high rate of tissue adequacy and production of a tissue core with this device with no adverse events seen in 200 patients. Comparative studies of different FNB needles are warranted in the future to help identify which needle type and size is ideal in different clinical settings.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

EUS-guided tissue sampling with a 20-gauge core biopsy needle for the characterization of gastrointestinal subepithelial lesions: Amulticenter study Highly accessed article p. 105
Filippo Antonini, Gabriele Delconte, Lorenzo Fuccio, Germana De Nucci, Carlo Fabbri, Elia Armellini, Leonardo Frazzoni, Adele Fornelli, Andrea Magarotto, Enzo Mandelli, Pietro Occhipinti, Enzo Masci, Gianpiero Manes, Giampiero Macarri
DOI:10.4103/eus.eus_1_18  PMID:29770781
Background and Objective: A new 20-gauge(G) biopsy needle with a core-trap technology has been developed with a large core size and enhanced flexibility. The aim of this multicenter study was to determine the feasibility, efficacy, and safety of EUS-guided fine-needle biopsy(EUS-FNB) with the new 20G needle in diagnosing subepithelial lesions(SELs). Materials and Methods: Retrospectively collected data from consecutive patients with SELs undergoing EUS-FNB with the 20G needle at five centers were analyzed. Results: A total of 50 SELs were included. The mean lesion size was 43.1±17.5mm. The lesion locations were esophagus(n=1), stomach(n=37), distal duodenum(n=5), rectum(n=6), and colon(n=1). The procedure was technically feasible in all patients. Definitive diagnosis with full histological assessment including immunohistochemistry was obtained in 88%(44/50) of the patients. Considering malignant versus benign lesions, the sensitivity, specificity, positive predictive value, and negative predictive value were 85%(95% confidence interval[CI] 70.2–94.3), 100%(95% CI 58.7%–100%), 100%(95% CI 85.1%–100%), and 62.5(95% CI 27.7–84.8), respectively. No major complications requiring additional care have been observed. Conclusions: In this multicenter study, we found that EUS-FNB with the new 20G core needle is an effective and safe method for the diagnosis of SELs with a high rate of producing adequate histological material and high diagnostic accuracy even from difficult-to-approach anatomical locations.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Prospective multicenter study of primary EUS-guided choledochoduodenostomy using a covered metal stent p. 111
Yousuke Nakai, Hiroyuki Isayama, Hiroshi Kawakami, Hirotoshi Ishiwatari, Masayuki Kitano, Yukiko Ito, Ichiro Yasuda, Hironari Kato, Saburo Matsubara, Atsushi Irisawa, Takao Itoi
DOI:10.4103/eus.eus_17_18  PMID:30168480
Background and Objectives: EUS-guided biliary drainage (EUS-BD) is increasingly reported as a salvage technique after failed endoscopic retrograde cholangiopancreatography, but it is still controversial whether EUS-BD can replace transpapillary biliary stenting. Therefore, we conducted this multicenter, prospective study of EUS-guided choledochoduodenostomy (EUS-CDS) using a covered metallic stent (CMS) as primary biliary drainage for unresectable distal malignant biliary obstruction (MBO). Methods: Patients with unresectable distal MBO without any prior drainage are enrolled. Primary endpoint is a technical success and secondary endpoints are adverse events, functional success, and recurrent biliary obstruction (RBO) of EUS-CDS. Clinical outcomes were compared between EUS-CDS and transpapillary stenting as a control. Results: A total of 34 patients were enrolled in 10 Japanese institutions. The cause of MBO was pancreatic cancer in 28 patients. Median tumor size and common bile duct diameter were 31 and 13 mm, respectively. Technical success rate was 97% with a median procedure time of 25 min and functional success rate was 100%. The rate of RBO was 29% and the causes of RBO were nontumor related: Migration in 18%, sludge/food impaction in 9%, and stent impaction to the duodenal wall in 3%. Other adverse events were abdominal pain in 6% and cholecystitis in 9%. A median cumulative time to RBO was 11.3 months. The rate of RBO and cumulative time to RBO of EUS-CDS were comparable to those of transpapillary stenting (36% and 9.1 months, respectively). Conclusion: EUS-CDS using a CMS as primary biliary drainage was technically feasible and its safety appeared comparable to transpapillary stenting.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Application of intraoperative ultrasonography in retroperitoneal laparoscopic partial nephrectomy: A single-center experience of recent 199 cases p. 118
Feiya Yang, Sai Liu, Lianjie Mou, Liyuan Wu, Xuesong Li, Nianzeng Xing
DOI:10.4103/eus.eus_15_19  
Objectives: To summarize the value and application experiences of intraoperative laparoscopic ultrasonography (ILUS) in retroperitoneal laparoscopic partial nephrectomy (RLPN). Materials and Methods: From January 2013 to December 2018, RLPN with ILUS was performed on the recent 199 patients in our center (two patients received bilateral RLPN due to suspected malignancy of both right and left sides), and the relevant clinical and follow-up data were retrospectively reviewed. Among them, 119 patients were male and 80 were female; the age of patients was 53.4 ± 12.3 years. Of all the renal tumors, 105 were located on the left side and 96 on the right side with a RENAL score of 6.6 ± 1.7. All the patients were diagnosed as or suspected of having a renal tumor by preoperative imaging examination. The ILUS was applied in all the operations to help locate the tumor, delineate the boundary, clarify the diagnosis, observe the blood supply, and so on. Results: RLPN with ILUS in these 199 patients was successfully performed without conversion to open surgery. All surgeries were completed in 90.2 ± 21.7 min, with 73.6 ± 89.2 mL for estimated blood loss, and 19.3 ± 5.6 min for warm ischemia time. The tumor size was 3.6 ± 1.5 cm, and all the surgical margins were negative. The drainage days and postoperative hospital days were 4.7 ± 2.3 and 6.1 ± 2.3, respectively. The preoperative creatinine was 69.7 ± 19.4 μmol/L compared with 61.6 ± 12.7 μmol/L measured 1 month postoperatively. There were 17 cases of renal cell carcinoma no more than 1 cm, and they were resected without artery clamp or a large amount of blood loss. Satellite tumors were confirmed in 12 cases, of which 8 were not detected by preoperative examinations and finally found by ILUS during surgeries. Conclusion: ILUS can alleviate the difficulty of preoperative diagnosis, facilitate surgical dissection, and improve the effect of nephron-sparing surgeries. Due to its great advantage, ILUS should further be promoted and applied.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
CASE REPORTS Top

“Invisible” pancreatic masses identified by EUS by the “ductal cutoff sign” p. 125
Kimberly J Fairley, David L Diehl, Amitpal S Johal
DOI:10.4103/eus.eus_49_15  PMID:30880727
Making a tissue diagnosis of pancreatic adenocarcinoma is best accomplished by EUS and fine-needle aspiration (FNA) of the lesion. Typically, a dark, or “hypoechoic” mass will be seen, which presents an obvious target for FNA. For small lesions, computerized tomography (CT) may be negative, but the lesion is still almost always seen on EUS imaging. Rarely, a pancreatic mass will appear isoechoic on EUS imaging. We report three “invisible” pancreatic masses identified only by a cutoff in the pancreatic duct (PD) and/or common bile duct (CBD). No mass, isoechoic or otherwise, was seen. EUS-FNA was performed in the area of ductal narrowing, with a positive identification of adenocarcinoma in these cases.
[ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
IMAGES AND VIDEOS Top

Mixed ductal-neuroendocrine carcinoma with unique intraductal growth in the main pancreatic duct Highly accessed article p. 129
Koji Hirata, Masaki Kuwatani, Tomoko Mitsuhashi, Ryo Sugiura, Shin Kato, Kazumichi Kawakubo, Toru Yamada, Toshimichi Asano, Satoshi Hirano, Naoya Sakamoto
DOI:10.4103/eus.eus_12_18  PMID:29786034
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Intrahepatic bile duct stone removal using peroral transluminal cholangioscopy (with videos) p. 131
Takeshi Ogura, Atsushi Okuda, Kazuhide Higuchi
DOI:10.4103/eus.eus_26_18  PMID:30246711
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta

Transluminal intrahepatic bile duct stone removal using coaxial basket catheter via the previously created EUS-guided hepaticogastrostomy tract (with videos) p. 133
Takeshi Ogura, Nobu Nishioka, Kazuhide Higuchi
DOI:10.4103/eus.eus_68_18  PMID:30880726
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [PubMed]  [Sword Plugin for Repository]Beta
LETTER TO EDITOR Top

A pilot study of a 20-mm lumen-apposing metal stent to treat pancreatic fluid collections: First reported multicenter use of a new device p. 136
Douglas G Adler, Shawn Mallery, Stuart Amateau, Jose Nieto, Linda Jo Taylor, Ali Siddiqui
DOI:10.4103/eus.eus_58_18  
[HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta
Feedback
Subscribe

Subscribe this journal
Submit articles
Most popular articles
Joiu us as a reviewer
Email alerts
Recommend this journal