Endoscopic Ultrasonography*
Charles Noyer, MD
Endoscopic ultrasound (EUS), first developed in 1980, has changed the approach to
the staging of gastrointestinal and non small-cell lung cancers (NSCLC), the diagnosis
and therapy of benign disorders of the pancreatico-biliary system, and abdominal
pain. Because scanning of tissue is performed from within the gastrointestinal lumen
at higher frequencies than during transabdominal ultrasound, EUS probes can delineate
the intestinal wall layers, increasing the accuracy of tumor staging and enabling
real-time sampling of lesions. Surrounding lymph nodes are easily identified and
fine needle aspiration enhances the sensitivity and specificity of tumor staging
procedure.
The sensitivity, specificity, and accuracy of EUS staging has been compared to other
imaging modalities including computed tomography (CT) and magnetic resonance imaging
(MRI) in many studies. Additionally, EUS is almost as sensitive as ERCP for the detection
of choledocholithiasis, without the risks inherent to the latter procedure; EUS can
be used to guide the performance of endoscopic cystgastrostomy or cystduodenostomy
for the drainage of pancreatic pseudocysts. EUS-guided celiac plexus neurolysis has
been performed for the intractable pain of pancreatic cancer and chronic pancreatitis.
Other indications for EUS include, evaluation of portal hypertension, adrenal masses,
and lesions in the left lobe of the liver, enlarged mediastinal lymph nodes, perianal
Crohnís disease, and inflammatory bowel disease. I will focus today on the uses of
EUS in pancreatico-biliary diseases. |
Abstracts
"Dome
Down" Laparoscopic Cholecystectomy
Glenn L. Sandler, MD
Endoscopic
Drainage of Pancreatic Pseudocyst
Gary C. Vitale, MD
Thoracoscopic
Splanchnicectomy for Pancreatic Pain
Henry L. Laws, MD
CT
Guided Percutaneous Drainage of Infected Acute Necrotizing Pancreatitis
Patrick C. Freeny, MD
Management
of Metastatic Carcinoma
T. S. Ravikumar, MD
Management
of Liver Trauma
Juan C. Asensio, MD
Management
of Benign Liver Tumors
Leslie H. Blumgart, MD, FRCS
Role
and Techniques of "Dome-Down" Laparoscopic Cholecystectomy
Glenn L. Sandler, MD
Thoracoscopic
Splanchnicectomy for Pancreatic Pain
Henry L. Laws, MD
Current
ConceptsæAdequate Pain Management
Young K. Choi, MD
Prevention
and Management of Infection Complicating Acute Pancreatitis
Henry L. Laws, MD
Indication
for and Timing of ERCP in Biliary Pancreatitis
John Baillie, MB, ChB, FRCP
Timing
of Laparoscopic Cholecystectomy After Biliary Pancreatitis
Gary C. Vitale
Magnetic
Resonance Angiography
Martin R. Prince, MD, PhD
Pancreatic
Imaging
Patrick C. Freeny, MD
Endoscopic
Ultrasonography
Charles Noyer, MD
Limited
Gastric Resection
Jo Buyske, MD
Current
ConceptsæManagement of Pancreatic Carcinoma
Henry A. Pitt, MD
Watchful
Waiting in the Management of Inguinal Hernia
Robert J. Fitzgibbons, MD
Treatment
of Incisional (Ventral) Hernias: Open Repair
Maximo Deysine, MD, FACP
Treatment
of Incisional (Ventral) Hernias: Laparoscopic Repair
Adrian E. Park, MD
Indications
for Converting to Open Operation
John G. Hunter, MD
Medicolegal
Implications of Common Bile Duct Injury During Laparoscopic Cholecystectomy
Kenneth A. Kern, MD, FACS
Role
and Technique of Pylorus Preserving Pacreatectomy
Henry A. Pitt, MD |
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