How to perform EUS in the pancreaticobiliary area

Area of Science:

• Gastroenterology
• Medical Imaging
• Endoscopy

Background:

• Endoscopic ultrasound (EUS) is crucial for diagnosing and managing pancreaticobiliary diseases.
• Accurate imaging of the pancreaticobiliary region is essential for effective patient care.

Purpose of the Study:

• To provide a detailed description of how to perform pancreaticobiliary examinations using both radial and linear EUS instruments.
• To outline specific techniques, patient positioning, and instrument manipulation for optimal visualization.

Main Methods:

• Describes patient positioning (left lateral decubitus, tilted 30-40°).
• Details techniques for radial EUS, including stomach and duodenal examination, and specific maneuvers for accessing the ampulla of Vater.
• Explains linear EUS methods, emphasizing balloon inflation, handle manipulation, and anatomical landmark navigation (vascular structures and ducts).

Main Results:

• Provides step-by-step instructions for navigating the stomach and duodenum with both radial and linear EUS scopes.
• Highlights the importance of anatomical knowledge for effective EUS examination of the pancreaticobiliary system.
• Demonstrates how to utilize specific maneuvers like the ERCP withdrawal maneuver for challenging anatomical access.

Conclusions:

• Mastery of these detailed EUS techniques is essential for comprehensive pancreaticobiliary examination.
• Proper application of radial and linear EUS facilitates accurate diagnosis and management of pancreaticobiliary conditions.