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Miyagawa K, Kajitani K, Makita T, Hideshima K, Shinohara N, Oe S, Honma Y, Shibata M, Harada M. An Unusual Abscess Associated with Gallbladder Perforation Successfully Treated with Percutaneous Transhepatic Gallbladder Drainage and Endoscopic Ultrasound-guided Abscess Drainage. Intern Med 2024; 63:2525-2531. [PMID: 38346739 DOI: 10.2169/internalmedicine.2963-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/18/2024] Open
Abstract
Abscesses associated with gallbladder perforation are often confined to the peri-gallbladder region. We herein report a rare case of gallbladder perforation in which the abscess cavity extended into the left upper quadrant. A 79-year-old woman developed gallbladder perforation secondary to acalculous cholecystitis. Computed tomography revealed fluid collection extending from the peri-gallbladder to the dorsal left hepatic lobe in contact with the stomach. We successfully treated percutaneous transhepatic gallbladder drainage and simultaneous endoscopic ultrasound-guided transgastric internal and external abscess drainage. This minimally invasive approach is considered safe and feasible for managing such a rare case.
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Affiliation(s)
- Koichiro Miyagawa
- The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - Kenta Kajitani
- The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - Takahiro Makita
- The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - Kosuke Hideshima
- The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - Nobuhiko Shinohara
- The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - Shinji Oe
- The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - Yuichi Honma
- The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - Michihiko Shibata
- The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - Masaru Harada
- The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
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Gadour E, Awad A, Hassan Z, Shrwani KJ, Miutescu B, Okasha HH. Diagnostic and therapeutic role of endoscopic ultrasound in liver diseases: A systematic review and meta-analysis. World J Gastroenterol 2024; 30:742-758. [PMID: 38515947 PMCID: PMC10950627 DOI: 10.3748/wjg.v30.i7.742] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 12/19/2023] [Accepted: 01/16/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND In hepatology, the clinical use of endoscopic ultrasound (EUS) has experienced a notable increase in recent times. These applications range from the diagnosis to the treatment of various liver diseases. Therefore, this systematic review summarizes the evidence for the diagnostic and therapeutic roles of EUS in liver diseases. AIM To examine and summarize the current available evidence of the possible roles of the EUS in making a suitable diagnosis in liver diseases as well as the therapeutic accuracy and efficacy. METHODS PubMed, Medline, Cochrane Library, Web of Science, and Google Scholar databases were extensively searched until October 2023. The methodological quality of the eligible articles was assessed using the Newcastle-Ottawa scale or Cochrane Risk of Bias tool. In addition, statistical analyses were performed using the Comprehensive Meta-Analysis software. RESULTS Overall, 45 articles on EUS were included (28 on diagnostic role and 17 on therapeutic role). Pooled analysis demonstrated that EUS diagnostic tests had an accuracy of 92.4% for focal liver lesions (FLL) and 96.6% for parenchymal liver diseases. EUS-guided liver biopsies with either fine needle aspiration or fine needle biopsy had low complication rates when sampling FLL and parenchymal liver diseases (3.1% and 8.7%, respectively). Analysis of data from four studies showed that EUS-guided liver abscess had high clinical (90.7%) and technical success (90.7%) without significant complications. Similarly, EUS-guided interventions for the treatment of gastric varices (GV) have high technical success (98%) and GV obliteration rate (84%) with few complications (15%) and rebleeding events (17%). CONCLUSION EUS in liver diseases is a promising technique with the potential to be considered a first-line therapeutic and diagnostic option in selected cases.
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Affiliation(s)
- Eyad Gadour
- Department of Gastroenterology and Hepatology, King Abdulaziz Hospital-National Guard, Ahsa 31982, Saudi Arabia
- Department of Internal Medicine, Faculty of Medicine, Zamzam University College, Khartoum 11113, Sudan
| | - Abeer Awad
- Department of Hepatogastroenterology, Kasar Alainy Hospital, Faculty of Medicine, Cairo University, Cairo 11451, Egypt
| | - Zeinab Hassan
- Department of Internal Medicine, Stockport Hospitals NHS Foundation Trust, Manchester SK2 7JE, United Kingdom
| | - Khalid Jebril Shrwani
- Public Health Authority, Saudi Center for Disease Prevention and Control, Jazan 45142, Saudi Arabia
- Department of Clinical Infection, Microbiology and Immunology, Institute of Infection and Global Health, School of Medicine and Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Bogdan Miutescu
- Department of Gastroenterology and Hepatology, Victor Babes University of Medicine and Pharmacy, Timisoara 300041, Romania
- Advanced Regional Research Center in Gastroenterology and Hepatology, Victor Babes University of Medicine and Pharmacy, Timisoara 30041, Romania
| | - Hussein Hassan Okasha
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kasr Al-Aini School of Medicine, Cairo University, Cairo 11562, Egypt
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Shah J, Jena A, Singh AK, Jearth V, Dutta U. Endoscopic Ultrasound (EUS)-guided Drainage of Caudate Lobe Abscess: A Single Center Experience. Surg Laparosc Endosc Percutan Tech 2023; 33:682-687. [PMID: 37725821 DOI: 10.1097/sle.0000000000001229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/17/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Liver abscess is usually treated with medical therapy. Few patients require drainage of the collection due to large size, certain high-risk location or rupture of the collection. Percutaneous drainage is most commonly used modality for the drainage of such collection. However, caudate lobe poses a unique difficulty in percutaneous drainage due to its deep location. METHODS We did a retrospective analysis of all patients with caudate lobe abscess who underwent endoscopic ultrasound (EUS)-guided drainage at our center. We reviewed their indications, technical and clinical success rates of the procedure from 2020 to 2023. We also performed systemic review of published literature till June 12, 2023 showing use of EUS-guided drainage of caudate lobe abscess. RESULTS Total of 8 patients (age: 37.33 ± 12.8 y; Males 62.5%) underwent EUS-guided drainage of caudate lobe collection at our center. Six patients underwent drainage using plastic stents, 1 patient underwent using metal stent, and 1 patient had aspiration of the abscess. Technical success was achieved in all patients. One patient succumbed to background illness and clinical success could be achieved in rest of the patients. In systemic review of literature on EUS-guided drainage of caudate lobe, a total of 10 studies (17 patients) were included. All patients achieved technical success. Majority studies reported use of plastic stents or naso-cystic drains whereas only 1 case reported use of metal stents. One procedure related complication (localized para-esophageal abscess) was reported requiring endoscopic intervention for management. CONCLUSION EUS-guided drainage of caudate lobe abscess is safe and effective. It should be used as a first-line intervention after a failed medical management.
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Affiliation(s)
- Jimil Shah
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Khizar H, Zhicheng H, Chenyu L, Yanhua W, Jianfeng Y. Efficacy and safety of endoscopic drainage versus percutaneous drainage for pancreatic fluid collection; a systematic review and meta-analysis. Ann Med 2023; 55:2213898. [PMID: 37243522 DOI: 10.1080/07853890.2023.2213898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/05/2023] [Accepted: 05/09/2023] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND/AIMS Pancreatic fluid collections (PFC) are debris or fluid of the pancreas that needs to be drained out. This may result from surgery or necrotizing pancreatitis. This meta-analysis compared the outcomes of PFC through endoscopic and percutaneous interventions. METHODS A medical database was searched up to June 2022, comparing the outcomes of endoscopic drainage (ED) and percutaneous drainage (PD) for the PFC. Eligible studies reporting clinical and technical success and adverse events were selected. RESULTS Seventeen studies with 1170 patients were included for meta-analysis, of which 543 patients underwent ED and 627 underwent PD. The odd ratio (OR) of technical success was 0.81 (95% confidence interval (CI) 0.31, 2.1) and clinical success was in the favor of the ED group at OR 2.23 (95% CI 1.45, 3.41). Adverse events OR 0.62 (95% CI 0.27, 1.39) and stent migration OR 0.61 (95% CI 0.10, 3.88) were the same in both groups, but hospital stay pooled mean difference of 15.02 days (95% CI 9.86, 20.18), mortality OR 0.24 (95% CI 0.09, 0.67), and re-interventions OR 0.25 (95% CI 0.16, 0.40) favored ED. CONCLUSIONS ED is safe and efficient for PFC with higher clinical success, lower mortality rate, hospital stay, and re-interventions compared with PD.
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Affiliation(s)
- Hayat Khizar
- Department of Gastroenterology, International Education College of Zhejiang Chinese Medical University, Hangzhou, China
- Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of medicine, Hangzhou, China
| | - Huang Zhicheng
- Department of Gastroenterology, The Fourth School of Clinical Medicine of Zhejiang Chinese Medical University, Hangzhou, China
| | - Le Chenyu
- Department of Gastroenterology, The Fourth School of Clinical Medicine of Zhejiang Chinese Medical University, Hangzhou, China
| | - Wu Yanhua
- Department of Gastroenterology, The Fourth School of Clinical Medicine of Zhejiang Chinese Medical University, Hangzhou, China
| | - Yang Jianfeng
- Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of medicine, Hangzhou, China
- Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Hangzhou, China
- Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang Province, Hangzhou, China
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Shahid H, Tyberg A, Sarkar A, Gaidhane M, Mahpour NY, Patel R, Flumignan VK, Vazquez-Sequeiros E, Martínez GM, Artifon EL, Kahaleh M. EUS-guided versus percutaneous liver abscess drainage: A multicenter collaborative study. Endosc Ultrasound 2023; 12:472-476. [PMID: 38948125 PMCID: PMC11213585 DOI: 10.1097/eus.0000000000000033] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/02/2024] Open
Abstract
Background and Objectives Management of hepatic abscesses has traditionally been performed by image-guided percutaneous techniques. More recently, EUS drainage has been shown to be efficacious and safe. The aim of this study is to compare EUS-guided versus percutaneous catheter drainage (PCD) of hepatic abscesses. Methods Patients who underwent EUS-guided drainage or PCD of hepatic abscesses from January 2018 through November 2021 from 4 international academic centers were included in a dedicated registry. Demographics, clinical data preprocedure and postprocedure, abscess characteristics, procedural data, adverse events, and postprocedure care were collected. Results Seventy-four patients were included (mean age, 63.9 years; 45% male): EUS-guided (n = 30), PCD (n = 44). Preprocedure Charlson Comorbidity Index scores were 4.3 for the EUS group and 4.3 for the PCD group. The median abscess size was 8.45 × 6 cm (length × width) in the EUS group versus 7.3 × 5.5 cm in the PCD group. All of the abscesses in the EUS group were left-sided, whereas the PCD group contained both left- and right-sided abscesses (29 and 15, respectively). Technical success was 100% in both groups. Ten-millimeter-diameter stents were used in most cases in the EUS group, and 10F catheters were used in the PCD group. The duration to resolution of symptoms from the initial procedure was 10.9 days less in the EUS group compared with the PCD group (P < 0.00001). Hospital length of stay was shorter in the EUS group by 5.2 days (P = 0.000126). The EUS group had significantly fewer number of repeat sessions: mean of 2 versus 7.7 (P < 0.00001) and trended toward fewer number of procedure-related readmissions: 10% versus 34%. The PCD group had a significantly higher number of adverse events (n = 27 [61%]) when compared with the EUS group (n = 5 [17%]; P = 0.0001). Conclusions EUS-guided drainage is an efficacious and safe intervention for the management of hepatic abscesses. EUS-guided drainage allows for quicker resolution of symptoms, shorter length of hospital stay, fewer adverse events, and fewer procedural sessions needed when compared with the PCD technique. However, EUS-guided drainage may not be feasible in right-sided lesions.
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Affiliation(s)
- Haroon Shahid
- Gastroenterology, Robert Wood Johnson University Hospital, New Brunswick, NJ
| | - Amy Tyberg
- Gastroenterology, Robert Wood Johnson University Hospital, New Brunswick, NJ
| | - Avik Sarkar
- Gastroenterology, Robert Wood Johnson University Hospital, New Brunswick, NJ
| | - Monica Gaidhane
- Gastroenterology, Robert Wood Johnson University Hospital, New Brunswick, NJ
| | - Noah Y. Mahpour
- Gastroenterology, Robert Wood Johnson University Hospital, New Brunswick, NJ
| | - Roohi Patel
- Gastroenterology, Robert Wood Johnson University Hospital, New Brunswick, NJ
| | | | | | | | | | - Michel Kahaleh
- Gastroenterology, Robert Wood Johnson University Hospital, New Brunswick, NJ
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Robles-Medranda C, Baquerizo-Burgos J, Alcivar-Vasquez J, Del Valle R, Tabacelia D. EUS-guided drainage of a segment VI liver abscess using a lumen-apposing metal stent. VIDEOGIE : AN OFFICIAL VIDEO JOURNAL OF THE AMERICAN SOCIETY FOR GASTROINTESTINAL ENDOSCOPY 2023; 8:316-318. [PMID: 37575142 PMCID: PMC10422084 DOI: 10.1016/j.vgie.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Video 1EUS-guided FNA and lumen-apposing metallic stent deployment.
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Affiliation(s)
| | | | | | - Raquel Del Valle
- Instituto Ecuatoriano de Enfermedades Digestivas (IECED), Guayaquil, Ecuador
| | - Daniela Tabacelia
- Instituto Ecuatoriano de Enfermedades Digestivas (IECED), Guayaquil, Ecuador
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Tanikawa T, Kawada M, Ishii K, Urata N, Nishino K, Suehiro M, Kawanaka M, Haruma K, Kawamoto H. Efficacy of endoscopic ultrasound-guided abscess drainage for non-pancreatic abscesses: A retrospective study. JGH Open 2023; 7:470-475. [PMID: 37496811 PMCID: PMC10366484 DOI: 10.1002/jgh3.12931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 05/20/2023] [Accepted: 05/24/2023] [Indexed: 07/28/2023]
Abstract
Background and Aim Percutaneous drainage of intra-abdominal abscesses is often uncomfortable for the patient and may result in prolonged hospital stays. Recent studies have shown that endoscopic ultrasound-guided abscess drainage (EUS-AD) could effectively treat various abscesses and fluid collections. However, no indications or procedures have been established for EUS-AD treatments, and studies on its usefulness and safety are insufficient. The present study aimed to evaluate the efficacy and safety of EUS-AD for treating non-pancreatic abscesses. Methods This retrospective study included 20 patients, aged ≥20 years, who underwent EUS-AD for an abscess or fluid accumulation in the abdomen or mediastinum, but not the pancreas. Patients were treated at the Kawasaki University General Medical Center between March 2013 and June 2021. All EUS-AD procedures were performed prior to a percutaneous drainage or surgical drainage. Results Among the 20 patients who underwent an EUS-AD for abscess, 8 (40%) had liver abscesses, 6 (30%) had intraperitoneal abscesses, 3 had (15%) splenic abscesses, 1 (5%) had a mediastinal abscess, 1 (5%) had an iliopsoas abscess (n = 1, 5%), and 1 (5%) had an abdominal wall abscess. The technical success rate was 95% (n = 19/20). We inserted nasobiliary catheters in 4/20 patients (20%). The clinical success rate was 90% (n = 18/20). Two clinical failures required reintervention, and both were treated with percutaneous drainage. Adverse events were observed in 2/20 patients (10%). One patient experienced fever after the procedure, and the other experienced localized peritonitis. Conclusion EUS-AD was effective and safe for abscess removal, particularly when approached from the upper gastrointestinal tract.
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Affiliation(s)
- Tomohiro Tanikawa
- Department of General Internal Medicine 2Kawasaki Medical SchoolOkayamaJapan
| | - Mayuko Kawada
- Department of General Internal Medicine 2Kawasaki Medical SchoolOkayamaJapan
| | - Katsunori Ishii
- Department of General Internal Medicine 2Kawasaki Medical SchoolOkayamaJapan
| | - Noriyo Urata
- Department of General Internal Medicine 2Kawasaki Medical SchoolOkayamaJapan
| | - Ken Nishino
- Department of General Internal Medicine 2Kawasaki Medical SchoolOkayamaJapan
| | - Mitsuhiko Suehiro
- Department of General Internal Medicine 2Kawasaki Medical SchoolOkayamaJapan
| | - Miwa Kawanaka
- Department of General Internal Medicine 2Kawasaki Medical SchoolOkayamaJapan
| | - Ken Haruma
- Department of General Internal Medicine 2Kawasaki Medical SchoolOkayamaJapan
| | - Hirofumi Kawamoto
- Department of General Internal Medicine 2Kawasaki Medical SchoolOkayamaJapan
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DʼErrico F, Derhy S, Fazi M, Memeo R, Decembrino F, De Palma GD, Donatelli G. EUS-guided endoscopic internal drainage with lumen-apposing metal stent for symptomatic hepatic cysts: a case series (with video). Endosc Int Open 2023; 11:E76-E80. [PMID: 36686030 PMCID: PMC9851806 DOI: 10.1055/a-1968-7596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 10/25/2022] [Indexed: 01/25/2023] Open
Abstract
Background and study aims Simple hepatic cysts (SHCs) are usually asymptomatic and detected incidentally. However, larger cysts may present with clinical signs and require treatment such as percutaneous aspiration or surgery with non negligeable rate of recurrence. We report a series of 13 consecutive patients who underwent EUS-guided lumen-apposing metal stent (LAMS) drainage of SHCs of the right and left liver. Patients and methods Nine men and four women, average age 71.9 years, underwent EUS-guided LAMS cyst drainage because of significant symptoms. At 1 month, LAMS was exchanged for a double pigtail stent (DPS), which was left in place for 3 months. Nine of the SHCs were located in the right liver and four in the left. The average diameter was 22.2 cm. Results Thirteen LAMS were successful delivered in all patients. However only 12 of 13 (92.3 %) remained in place. In one case, the LAMS slipped out immediately and was promptly removed and the cyst treated percutaneously. One of 12 patients experienced bleeding, which was treated conservatively. In seven patients, the LAMS was exchanged for a DPS; in the other five, it was successfully left in place until the patients died, given their comorbidities. At 10.5 months of follow-up, none of the SHCs had recurred. Conclusions EUS-guided LAMS drainage permits treatment of symptomatic SHCs without recurrence and with few adverse events. Comparative studies are needed to consider this approach as first intention.
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Affiliation(s)
- Francesca DʼErrico
- Unité dʼEndoscopie Interventionnelle, Hôpital Privé des Peupliers, Ramsay Santé, Paris, France,Unit of Gastroenterology and Digestive Endoscopy, “F. Miulli” General Regional Hospital, Acquaviva delle Fonti
| | - Serge Derhy
- Unité dʼEndoscopie Interventionnelle, Hôpital Privé des Peupliers, Ramsay Santé, Paris, France
| | - Maurizio Fazi
- Unité dʼEndoscopie Interventionnelle, Hôpital Privé des Peupliers, Ramsay Santé, Paris, France
| | - Riccardo Memeo
- Unit of Hepato-Pancreatic-Biliary Surgery, “F. Miulli” General Regional Hospital, Acquaviva delle Fonti
| | - Francesco Decembrino
- Unit of Gastroenterology and Digestive Endoscopy, “F. Miulli” General Regional Hospital, Acquaviva delle Fonti
| | - Giovanni D. De Palma
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Gianfranco Donatelli
- Unité dʼEndoscopie Interventionnelle, Hôpital Privé des Peupliers, Ramsay Santé, Paris, France,Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
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Fuentes-Valenzuela E, Burgueño Gomez B, Chavarría C, Sanchez-Ocana R, de la Serna-Higuera C, Perez-Miranda M. Endoscopic ultrasound-guided drainage of a liver abscess with a self-expandable metal stent as rescue therapy after plastic stent misdeployment. Endoscopy 2022; 55:E328-E329. [PMID: 36516946 PMCID: PMC9833947 DOI: 10.1055/a-1974-9558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
| | | | - Carlos Chavarría
- Gastroenterology Department, Hospital Universitario Rio Hortega, Valladolid, Spain
| | - Ramon Sanchez-Ocana
- Gastroenterology Department, Hospital Universitario Rio Hortega, Valladolid, Spain
| | | | - Manuel Perez-Miranda
- Gastroenterology Department, Hospital Universitario Rio Hortega, Valladolid, Spain
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Okuno N, Hara K, Mizuno N, Haba S, Kuwahara T, Kuraishi Y, Yanaidani T, Ishikawa S, Yasuda T, Yamada M, Fukui T. Endoscopic ultrasound-guided drainage for an abscess cavity. INTERNATIONAL JOURNAL OF GASTROINTESTINAL INTERVENTION 2022. [DOI: 10.18528/ijgii220051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Nozomi Okuno
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Kazuo Hara
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Nobumasa Mizuno
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Shin Haba
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Takamichi Kuwahara
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yasuhiro Kuraishi
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Takafumi Yanaidani
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Sho Ishikawa
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Tsukasa Yasuda
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Masanori Yamada
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Toshitaka Fukui
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
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Jearth V, Sundaram S, Rana SS. Diagnostic and interventional EUS in hepatology: An updated review. Endosc Ultrasound 2022; 11:355-370. [PMID: 36255023 PMCID: PMC9688142 DOI: 10.4103/eus-d-22-00027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
EUS has become an increasingly used diagnostic and therapeutic modality in the armamentarium of endoscopists. With ever-expanding indications, EUS is being used in patients with liver disease, for both diagnosis and therapy. EUS is playing an important role in providing additional important information to that provided by cross-sectional imaging modalities such as computerized tomography and magnetic resonance imaging. Domains of therapy that were largely restricted to interventional radiologists have become accessible to endosonologists. From liver biopsy and sampling of liver lesions to ablative therapy for liver lesions and vascular interventions for varices, there is increased use of EUS in patients with liver disease. In this review, we discuss the various diagnostic and therapeutic applications of EUS in patients with various liver diseases.
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Affiliation(s)
- Vaneet Jearth
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sridhar Sundaram
- Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Surinder Singh Rana
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India,Address for correspondence Prof. Surinder Singh Rana, Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh - 160 012, India. E-mail:
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12
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Zanwar S, Agrawal A. Endosonography-Guided Caudate Lobe Liver Abscess Drainage: A Case and Review of Methods. JOURNAL OF DIGESTIVE ENDOSCOPY 2022. [DOI: 10.1055/s-0042-1747912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
AbstractThere are only 11 cases of caudate lobe liver abscess drainage described in the published literature. We present a case of liver abscess drainage done by endosonography (EUS) and review of various EUS-guided liver abscess drainage techniques and endoprostheses. Here we have aimed at reviewing the data for paving the way for the development of a consensus for liver abscess drainage.
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Affiliation(s)
- Shankar Zanwar
- Department of Gastroenterology, Care Hospitals, Nagpur, India
| | - Amit Agrawal
- Department of Gastroenterology, Disha Clinics, Nagpur, India
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13
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Jing X, Liu S, Tian Z, Jiang Y, Mao T, Ding X. Endoscopic ultrasound-guided drainage to abdominal abscess: A systematic review and meta-analysis. J Minim Access Surg 2022; 18:489-496. [PMID: 35915535 PMCID: PMC9632695 DOI: 10.4103/jmas.jmas_349_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Ultrasound (US)- or computed tomography-guided drainage for abdominal abscess is currently the first-line options for drainage, but both options have disadvantages. Patients without adequate windows for drainage mostly undergo surgical drainage. However, surgical drainage is invasive and expensive. Endoscopic US (EUS)-guided drainage is a minimally invasive alternative for abdominal abscess, but there is less consensus on its efficacy, safety and complications. This meta-analysis aims to evaluate EUS-guided drainage for abdominal abscess. Materials and Methods: We retrieved relevant papers on EUS-guided drainage for abdominal abscess from the PubMed, Cochrane Library, Web of Science and EMBASE databases. Each paper was reviewed, and data were extracted. We used R software version 3.6.3 to perform the meta-analysis. Fixed effects models were used for merging data. Results: A total of 11 papers met the inclusion criteria, with a total sample population of 264 patients. The meta-analysis showed that the pooled clinical success rate was 90% (95% confidence interval [CI], 0.85–0.95), the technical success rate was 99% (95% CI, 0.97–1.00) and the recurrence rate was 1% (95% CI, 0.00–0.03). Three studies reported the complications, including perforation, bleeding and stent migration; none of the other eight studies reported complications. There were no significant differences between subgroups. There was no publication bias in either the clinical or the technical success rates. Conclusions: This meta-analysis showed that EUS-guided drainage for abdominal abscess was effective and safe, with an excellent technical success rate. In addition, EUS-guided drainage could be used for abscesses with complex anatomy. Nevertheless, complications and stent type should be considered.
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Pavic T, Mikolasevic I, Kralj D, Blazevic N, Skrtic A, Budimir I, Lerotic I, Hrabar D. Role of Endoscopic Ultrasound in Liver Disease: Where Do We Stand? Diagnostics (Basel) 2021; 11:2021. [PMID: 34829368 PMCID: PMC8618190 DOI: 10.3390/diagnostics11112021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/25/2021] [Accepted: 10/29/2021] [Indexed: 12/13/2022] Open
Abstract
As the burden of liver disease in the general populace steadily increases, so does the need for both advanced diagnostic and treatment options. Endoscopic ultrasound is a reliable diagnostic and therapeutic method that has an established role, foremost in pancreatobiliary pathology. This paper aims to summarize the growing role of endoscopic ultrasound in hepatology based on the search of the current literature. A number of applications of endoscopic ultrasound are reviewed, including both noninvasive methods and tissue acquisition in focal and diffuse liver disease, portal hypertension measurement, detection and management of gastric and esophageal varices, treatment of focal liver lesions and staging of pancreatobiliary malignancies, treatment of cystic and solid liver lesions, as well as liver abscess drainage. Both hepatologists and endoscopists should be aware of the evolving role of endoscopic ultrasound in liver disease. The inherent invasive nature of endoscopic examination limits its use to a targeted population identified using noninvasive methods. Endoscopic ultrasound is one the most versatile methods in gastroenterology, allowing immediate access with detection, sampling, and treatment of digestive tract pathology. Further expansion of its use in hepatology is immanent.
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Affiliation(s)
- Tajana Pavic
- Department of Gastroenterology and Hepatology, University Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia; (D.K.); (N.B.); (I.B.); (I.L.); (D.H.)
| | - Ivana Mikolasevic
- Department of Gastroenterology, University Hospital Center Rijeka, 51000 Rijeka, Croatia;
| | - Dominik Kralj
- Department of Gastroenterology and Hepatology, University Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia; (D.K.); (N.B.); (I.B.); (I.L.); (D.H.)
| | - Nina Blazevic
- Department of Gastroenterology and Hepatology, University Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia; (D.K.); (N.B.); (I.B.); (I.L.); (D.H.)
| | - Anita Skrtic
- Department of Pathology, Merkur University Hospital, 10000 Zagreb, Croatia;
| | - Ivan Budimir
- Department of Gastroenterology and Hepatology, University Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia; (D.K.); (N.B.); (I.B.); (I.L.); (D.H.)
| | - Ivan Lerotic
- Department of Gastroenterology and Hepatology, University Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia; (D.K.); (N.B.); (I.B.); (I.L.); (D.H.)
| | - Davor Hrabar
- Department of Gastroenterology and Hepatology, University Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia; (D.K.); (N.B.); (I.B.); (I.L.); (D.H.)
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15
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Endoscopic ultrasound-guided drainage of a fungal liver abscess using a lumen-apposing metal stent: case report and literature review. ACTA ACUST UNITED AC 2021; 59:93-98. [PMID: 33170145 DOI: 10.2478/rjim-2020-0035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Indexed: 11/20/2022]
Abstract
Liver abscesses are rare entities for which percutaneous drainage is traditionally employed. The technique is simple, but associated with a significant rate of side effects and patient discomfort. We herein report a case of fungal left liver lobe abscess that was successfully treated by using EUS-guided drainage, with insertion of a large caliber lumen-apposing metal stent. The literature review we performed on the topic seems to favor, at least for abscess in the left and/or caudate liver lobes, EUS as compared to percutaneous drainage.
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16
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Chandra S, Chandra U. Endoscopic ultrasound-guided transgastric drainage of radiologically inaccessible left lobe liver abscess involving segment 4, caudate lobe, and left lateral segments using a modified technique. Endosc Int Open 2021; 9:E35-E40. [PMID: 33403234 PMCID: PMC7775807 DOI: 10.1055/a-1293-7746] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 09/30/2020] [Indexed: 01/19/2023] Open
Abstract
Liver abscess requiring drainage is conventionally managed by interventional radiology-guided percutaneous drainage (PCD). Radiologically inaccessible abscesses are managed with laparoscopic or open surgery, which carries high rates of morbidity and mortality. EUS-guided transluminal liver abscess drainage is minimally invasive and can be an alternative approach for caudate lobe, segment 4, and left lateral segment abscesses. We report on three consecutive patients with radiologically inaccessible left lobe liver abscess involving the caudate lobe, segment 4, and lateral segment in whom EUS-guided transluminal drainage using a modified technique was successful.
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Affiliation(s)
- Sharad Chandra
- Department of Gastroenterology, Meghraj Memorial Hospital, Jhansi, Uttar Pradesh, India
| | - Urvashi Chandra
- Department of Gastroenterology, Meghraj Memorial Hospital, Jhansi, Uttar Pradesh, India
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17
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Hashimoto R, Chang KJ. Endoscopic ultrasound guided hepatic interventions. Dig Endosc 2021; 33:54-65. [PMID: 32145117 DOI: 10.1111/den.13661] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 03/03/2020] [Indexed: 02/08/2023]
Abstract
Intervention for liver disease has predominantly been performed through the percutaneous approach. However, as endoscopic ultrasound (EUS) applications have expanded, there have emerged various EUS-guided interventions for liver disease, a space we call "Endo-Hepatology". EUS-guided liver biopsy can be considered the "forerunner" of Endo-Hepatology and has become a clinical option for patients requiring histologic diagnosis and staging of their liver disease. EUS also enables direct access to the portal vein. Subsequently, many procedures are being explored, such as angiography, measurement of the portosystemic pressure gradient, portal vein sampling to detect cancer cell or DNA, and EUS-guided transhepatic intrahepatic portosystemic shunt creation. Since the transducer is close to the liver, especially the left and caudate lobes, EUS can be used as a rescue when the percutaneous approach is not favorable and EUS-guided treatments of liver tumor, cyst and abscess have been reported. This review summarizes the available studies of EUS-guided intervention in the liver.
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Affiliation(s)
- Rintaro Hashimoto
- H. H. Chao Comprehensive Digestive Center, University of California Irvine Medical Center, Orange, USA
| | - Kenneth J Chang
- H. H. Chao Comprehensive Digestive Center, University of California Irvine Medical Center, Orange, USA
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18
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Cai QC, Zhang YX, Liao Y, Gong JP, Xiong B. Is endoscopic drainage better than percutaneous drainage for patients with pancreatic fluid collections? A comparative meta-analysis. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2020; 113:454-462. [PMID: 33267596 DOI: 10.17235/reed.2020.7170/2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION though endoscopic and percutaneous drainage have emerged as the most common minimally invasive treatments for pancreatic fluid collections (PFCs), estimates of therapeutic superiority for either treatment have yielded inconsistent results. METHODS we retrieved studies comparing the efficacy and safety of these two approaches in PubMed, Embase, and the Cochrane Library. Primary outcomes were differences in technical success, clinical success, and adverse events, and secondary outcomes included differences in reintervention, need for surgical intervention, mortality, recurrence rate, and length of hospital stay. RESULTS there were nonsignificant differences in technical success rate (OR 0.54; CI: 0.15-1.86), clinical success rate (OR 1.39; CI: 0.82-2.37), adverse events rate (OR 1.21; CI: 0.70-2.11), mortality rate (OR 0.81; CI: 0.30-2.16), and recurrence rate (OR 1.94; CI 0.74-5.07) between the two groups. Reintervention rate (OR 0.19; CI: 0.08-0.45) and percentage of need for surgical intervention (OR 0.08; CI: 0.02-0.39) in the endoscopic drainage group were much lower than in the percutaneous drainage group. Total length of hospital stay (standard mean difference [SMD] -0.60; CI: -0.84 to -0.36) in the endoscopic drainage group was shorter; however, there was a nonsignificant difference in the length of post-procedure hospital stay (SMD: -0.30; CI: -1.05-0.44) between the two groups. CONCLUSION endoscopic drainage is effective for PFCs, and superior in terms of lower reintervention and need for surgery rates over traditional percutaneous drainage, despite a similar clinical efficacy and safety compared with traditional percutaneous drainage.
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Affiliation(s)
- Qi-Chen Cai
- Hepatobiliary Surgery. The Second Affiliated Hospital. Chongqing Medical University,Hepatobiliary Pancreatic Surgery. The Second People's Hospital of Chengdu
| | - Yu-Xin Zhang
- Hepatobiliary Surgery. The Second Affiliated Hospital. Chongqing Medical University
| | - Yang Liao
- Hepatobiliary Surgery. The Second Affiliated Hospital. Chongqing Medical University
| | - Jian-Ping Gong
- Hepatobiliary Surgery. The Second Affiliated Hospital. Chongqing Medical University
| | - Bin Xiong
- Hepatobiliary Surgery. The Second Affiliated Hospital. Chongqing Medical University
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Hijos G, Abad D, Laredo V, Alfaro E, Cañamares P, García S, Velamazán R, Hernández M, Saura N, Sostres C. Abscess secondary to complicated peptic ulcer managed by endoscopic ultrasound-guided drainage with a lumen-apposing metal stent. GASTROENTEROLOGIA Y HEPATOLOGIA 2020; 44:128-130. [PMID: 32718839 DOI: 10.1016/j.gastrohep.2020.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/08/2020] [Accepted: 04/28/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Gonzalo Hijos
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.
| | - Daniel Abad
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - Viviana Laredo
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - Enrique Alfaro
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | | | - Sandra García
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - Raúl Velamazán
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - María Hernández
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - Nuria Saura
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - Carlos Sostres
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
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Chin YK, Asokkumar R. Endoscopic ultrasound-guided drainage of difficult-to-access liver abscesses. SAGE Open Med 2020; 8:2050312120921273. [PMID: 32435490 PMCID: PMC7222655 DOI: 10.1177/2050312120921273] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 04/02/2020] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Antibiotic therapy and percutaneous drainage have been the first-line treatments for liver abscesses. However, percutaneous drainage of abscesses may be challenging in difficult-to-access locations such as the caudate lobe. The aim of this review was to determine the indications, technical feasibility and efficacy of endoscopic ultrasound-guided drainage of difficult-to-access liver abscesses. METHODS A literature review of original articles, abstracts, case series and case reports describing endoscopic ultrasound-guided liver abscess drainage was performed. The indications, techniques and complications associated with endoscopic ultrasound-guided drainage were reviewed. RESULTS A total of 15 studies were identified. The main indications were failed antibiotic therapy and difficulty in gaining percutaneous access. The technique involved identification and puncturing of an abscess under endoscopic ultrasound guidance followed by placement of a prosthesis via a guide wire. The technique was 97.5% successful with no major complications reported. CONCLUSION Endoscopic ultrasound-guided drainage was feasible and safe and allowed complete drainage of liver abscesses not accessible by percutaneous drainage.
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Affiliation(s)
- Yung Ka Chin
- Department of Gastroenterology and Hepatology, Academia, Singapore General Hospital, Singapore
| | - Ravishankar Asokkumar
- Department of Gastroenterology and Hepatology, Academia, Singapore General Hospital, Singapore
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