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Moutinho-Ribeiro P, Costa-Moreira P, Caldeira A, Leite S, Marques S, Moreira T, Nunes N, Bispo M. Endoscopic Ultrasound-Guided Celiac Plexus Interventions. GE-PORTUGUESE JOURNAL OF GASTROENTEROLOGY 2021; 28:32-38. [PMID: 33564702 DOI: 10.1159/000508293] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 04/23/2020] [Indexed: 12/26/2022]
Abstract
Abdominal pain related to pancreatic disease is often extremely disabling. Endoscopic ultrasound (EUS)-guided celiac plexus block (CPB) is used to control pain associated with chronic pancreatitis. EUS-guided celiac plexus neurolysis (CPN) is typically used to reduce pain associated with pancreatic cancer and can be considered early at the time of diagnosis of inoperable disease. EUS-guided celiac plexus interventions have been shown to be significantly effective in pancreatic pain relief, which is achieved in approximately 70-80% of patients with pancreatic cancer and in 50-60% of those with chronic pancreatitis. Serious complications from CPB and CPN are rare. Most frequent adverse events are diarrhoea, orthostatic hypotension, and a transient increase in abdominal pain. In this article, the Portuguese Group for Ultrasound in Gastroenterology (GRUPUGE) presents an updated perspective of the potential role of EUS-guided celiac plexus interventions, addressing the selection criteria and technical issues of different techniques and analysing recent data on their safety and efficacy.
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Affiliation(s)
- Pedro Moutinho-Ribeiro
- Gastroenterology Department, Centro Hospitalar e Universitário São João, Porto, Portugal.,Faculty of Medicine, University of Porto, Porto, Portugal
| | - Pedro Costa-Moreira
- Gastroenterology Department, Centro Hospitalar e Universitário São João, Porto, Portugal.,Faculty of Medicine, University of Porto, Porto, Portugal
| | - Ana Caldeira
- Department of Gastroenterology, Hospital Amato Lusitano, Castelo Branco, Portugal
| | - Sílvia Leite
- Department of Gastroenterology, Hospital da Senhora da Oliveira, Guimarães, Portugal
| | - Susana Marques
- Department of Gastroenterology and Digestive Endoscopy, Champalimaud Foundation, Lisbon, Portugal
| | - Teresa Moreira
- Department of Gastroenterology, Centro Hospitalar Universitário do Porto, Hospital de Santo António, Porto, Portugal
| | - Nuno Nunes
- Department of Gastroenterology, Hospital do Divino Espírito Santo de Ponta Delgada, Ponta Delgada, Portugal
| | - Miguel Bispo
- Department of Gastroenterology and Digestive Endoscopy, Champalimaud Foundation, Lisbon, Portugal
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Tontini GE, Manfredi G, Orlando S, Neumann H, Vecchi M, Buscarini E, Elli L. Endoscopic ultrasonography and small-bowel endoscopy: Present and future. Dig Endosc 2019; 31:627-643. [PMID: 31090965 DOI: 10.1111/den.13429] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 05/13/2019] [Indexed: 12/12/2022]
Abstract
Over the last decade, impressive technological advances have occurred in ultrasonography and small-bowel endoscopy. Nowadays, endoscopic ultrasonography is an essential diagnostic tool and a therapeutic weapon for pancreatobiliary disorders. Capsule endoscopy and device-assisted enteroscopy have quickly become the reference standard for the diagnosis of small-bowel luminal diseases, thereby leading to radical changes in diagnostic and therapeutic pathways. We herein provide an up-to-date overview of the latest advances in endoscopic ultrasonography and small-bowel endoscopy, focusing on the emerging paradigms and technological innovations that might improve clinical practice in the near future.
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Affiliation(s)
- Gian Eugenio Tontini
- Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | | | - Stefania Orlando
- Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Digestive Endoscopy and Gastroenterology Unit, ASST of Cremona, Cremona, Italy
| | - Helmut Neumann
- Department of Medicine I, University Medical Center Mainz, Mainz, Germany
| | - Maurizio Vecchi
- Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | | | - Luca Elli
- Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Cazacu IM, Luzuriaga Chavez AA, Saftoiu A, Vilmann P, Bhutani MS. A quarter century of EUS-FNA: Progress, milestones, and future directions. Endosc Ultrasound 2018; 7:141-160. [PMID: 29941723 PMCID: PMC6032705 DOI: 10.4103/eus.eus_19_18] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 03/21/2018] [Indexed: 12/11/2022] Open
Abstract
Tissue acquisition using EUS has considerably evolved since the first EUS-FNA was reported 25 years ago. Its introduction was an important breakthrough in the endoscopic field. EUS-FNA has now become a part of the diagnostic and staging algorithm for the evaluation of benign and malignant diseases of the gastrointestinal tract and of the organs in its proximity, including lung diseases. This review aims to present the history of EUS-FNA development and to provide a perspective on the recent developments in procedural techniques and needle technologies that have significantly extended the role of EUS and its clinical applications. There is a bright future ahead for EUS-FNA in the years to come as extensive research is conducted in this field and various technologies are continuously implemented into clinical practice.
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Affiliation(s)
- Irina Mihaela Cazacu
- Department of Gastroenterology, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy, Craiova, Romania
- Department of Gastroenterology, Hepatology, and Nutrition, University of Texas – MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Adrian Saftoiu
- Department of Gastroenterology, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy, Craiova, Romania
| | - Peter Vilmann
- Gastrounit, Division of Surgery, Copenhagen University Hospital Herlev, Copenhagen, Denmark
| | - Manoop S. Bhutani
- Department of Gastroenterology, Hepatology, and Nutrition, University of Texas – MD Anderson Cancer Center, Houston, Texas, USA
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Tang SJ, Vilmann AS, Saftoiu A, Wang W, Streba C, Fink PP, Griswold M, Wu R, Dietrich CF, Jenssen C, Hocke M, Kantowski M, Pohl J, Fockens P, Annema JT, van der Heijden EH, Havre RF, Pham KDC, Kunda R, Deprez PH, Mariana J, Vazquez-Sequeiros E, Larghi A, Buscarini E, Fusaroli P, Lahav M, Puri R, Garg PK, Sharma M, Maluf-Filho F, Sahai A, Brugge WR, Lee LS, Aslanian HR, Wang AY, Shami VM, Markowitz A, Siddiqui AA, Mishra G, Scheiman JM, Isenberg G, Siddiqui UD, Shah RJ, Buxbaum J, Watson RR, Willingham FF, Bhutani MS, Levy MJ, Harris C, Wallace MB, Nolsøe CP, Lorentzen T, Bang N, Sørensen SM, Gilja OH, D’Onofrio M, Piscaglia F, Gritzmann N, Radzina M, Sparchez ZA, Sidhu PS, Freeman S, McCowan TC, de Araujo CR, Patel A, del Ali MA, Campbell G, Chen E, Vilmann P. EUS Needle Identification Comparison and Evaluation study (with videos). Gastrointest Endosc 2016; 84:424-433.e2. [PMID: 26873530 PMCID: PMC5570521 DOI: 10.1016/j.gie.2016.01.068] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 01/29/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS EUS-guided FNA or biopsy sampling is widely practiced. Optimal sonographic visualization of the needle is critical for image-guided interventions. Of the several commercially available needles, bench-top testing and direct comparison of these needles have not been done to reveal their inherent echogenicity. The aims are to provide bench-top data that can be used to guide clinical applications and to promote future device research and development. METHODS Descriptive bench-top testing and comparison of 8 commonly used EUS-FNA needles (all size 22 gauge): SonoTip Pro Control (Medi-Globe); Expect Slimline (Boston Scientific); EchoTip, EchoTip Ultra, EchoTip ProCore High Definition (Cook Medical); ClearView (Conmed); EZ Shot 2 (Olympus); and BNX (Beacon Endoscopic), and 2 new prototype needles, SonoCoat (Medi-Globe), coated by echogenic polymers made by Encapson. Blinded evaluation of standardized and unedited videos by 43 EUS endoscopists and 17 radiologists specialized in GI US examination who were unfamiliar with EUS needle devices. RESULTS There was no significant difference in the ratings and rankings of these needles between endosonographers and radiologists. Overall, 1 prototype needle was rated as the best, ranking 10% to 40% higher than all other needles (P < .01). Among the commercially available needles, the EchoTip Ultra needle and the ClearView needle were top choices. The EZ Shot 2 needle was ranked statistically lower than other needles (30%-75% worse, P < .001). CONCLUSIONS All FNA needles have their inherent and different echogenicities, and these differences are similarly recognized by EUS endoscopists and radiologists. Needles with polymeric coating from the entire shaft to the needle tip may offer better echogenicity.
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Affiliation(s)
- Shou-jiang Tang
- Division of Digestive Diseases, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | | | - Adrian Saftoiu
- Gastro Unit, Copenhagen University Hospital Herlev, Copenhagen, Denmark
- Department of Gastroenterology, Research Center of Gastroenterology and Hepatology Craiova, Craiova, Romania
| | - Wanmei Wang
- Center of Biostatistics & Bioinformatics, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Costin Streba
- Department of Gastroenterology, Research Center of Gastroenterology and Hepatology Craiova, Craiova, Romania
| | | | - Michael Griswold
- Center of Biostatistics & Bioinformatics, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Ruonan Wu
- Division of Digestive Diseases, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | | | | | | | | | - Jürgen Pohl
- Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | | | | | | | | | | | | | | | - Jinga Mariana
- University of Medicine and Pharmacy, Bucharest, Romania
| | | | | | | | - Pietro Fusaroli
- Department of Medical and Surgical Sciences, University of Bologna/Hospital of Imola, Italy
| | | | - Rajesh Puri
- Institute of Digestive and Hepatobiliary Sciences, Gurgaon, India
| | | | - Malay Sharma
- Jaswant Rai Speciality Hospital, Uttar Pradersh, India
| | | | - Anand Sahai
- Centre Hospitalier de l’Universite de Montreal, Canada
| | | | - Linda S. Lee
- Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | | | - Andrew Y. Wang
- University of Virginia Health System, Division of Gastroenterology and Hepatology, Charlottesville, Virginia, USA
| | - Vanessa M. Shami
- University of Virginia Health System, Division of Gastroenterology and Hepatology, Charlottesville, Virginia, USA
| | | | - Ali A. Siddiqui
- Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Girish Mishra
- Wake Forest University Hospital, Winston-Salem, North Carolina, USA
| | | | | | | | - Raj J. Shah
- University of Colorado Hospital, Denver, Colorado, USA
| | - James Buxbaum
- University of Southern California Keck School of Medicine, California, USA
| | | | | | | | | | | | | | | | - Torben Lorentzen
- Gastro Unit, Copenhagen University Hospital Herlev, Copenhagen, Denmark
| | - Niels Bang
- Aarhus University Hospital, Aarhus, Denmark
| | | | - Odd Helge Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, and Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | | | - Fabio Piscaglia
- Department of Medical and Surgical Sciences, University of Bologna/Hospital of Imola, Italy
| | | | - Maija Radzina
- Paula Stradina Clinical University Hospital, Riga, Latvia
| | - Zeno Adrian Sparchez
- 3rd Medical Department, University of Medicine and Pharmacy, Institute for Gastroenterology and Hepatology, Cluj-Napoca, Romania
| | | | | | | | | | - Akash Patel
- University of Mississippi Medical Center, Jackson, Mississippi, USA
| | | | - Garth Campbell
- University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Edward Chen
- UT Southwestern Medical Center, Dallas, Texas, USA
| | - Peter Vilmann
- Gastro Unit, Copenhagen University Hospital Herlev, Copenhagen, Denmark
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