Clin Endosc.  2011 Sep;44(1):6-12.

Interventional Endoscopic Ultrasonography: Present and Future

• Lee KH
• Lee JK

Abstract

The technical advances in endoscopic ultrasonograpy (EUS) and accessories have enabled performing EUS-guided intervention in the pancreas and biliary tract. Many research centers have been performing or investigating EUS-guided drainage, EUS-guided celiac plexus neurolysis and block, EUS-guided anastomosis that includes choledocho-enterostomy and choledocho-gastrostomy, EUS-guided ablation and injection therapy mainly for pancreatic neoplasm, EUS-guided photodynamic therapy and EUS-guided brachytherapy. Some of these are currently clinical applications and others are under investigations in clinical studies or animal models. Further detailed randomized controlled clinical trials and the development of materials will bring us into a new era of therapeutic EUS.

Keyword

Endoscopic ultrasonograpy; Intervention; Drainage; Anastomosis; Neurolysis

MeSH Terms

Biliary Tract
Brachytherapy
Celiac Plexus
Drainage
Models, Animal
Pancreas
Pancreatic Neoplasms
Photochemotherapy

Figure

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  Fig. 1 Endoscopic ultrasonograpy (EUS)-guided pseudocyst drainage. After EUS-guided puncture of pseudocyst (A) and dilatation of puncture site, pus was coming out from infected pseudocyst (B). Endoscopic nasobiliary drainage tube would be inserted over guide wire to irrigate the cyst after a pigtail plastic stent was inserted (C).

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  Fig. 2 Choledochoduodenostomy. Due to duodenal partial obstruction, a transpapillary metal stent insertion was impossible. After endoscopic ultrasonograpy-guided puncture of dilated common bile duct (CBD) (A), fully covered metal stent was inserted from duodenal bulb to distal CBD (B).

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  Fig. 3 Hepaticogastrostomy. Jaundice hadn't resolved after percutaneous and endoscopic drainage. Endoscopic ultrasonograpy-guided puncture of a dilated left intrahepatic duct (A) and placement of metal stent (B) was performed.

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