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Related Concept Videos

Ultrasound II: Endoscopic Ultrasound and FibroScan01:25

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Endoscopic Ultrasound (EUS) and FibroScan are valuable diagnostic tools in gastroenterology and hepatology, each with specific applications and techniques.
Endoscopic Ultrasound (EUS):
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Endoscopic ultrasonography-guided tumor ablation.

Sundeep Lakhtakia1, Dong-Wan Seo2

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Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society
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Endoscopic ultrasound (EUS) now guides interventions like tumor ablation and pain management. This minimally invasive approach offers new hope for pancreatic cancer patients, especially those ineligible for surgery.

Keywords:
endoscopic ultrasound (EUS)ethanol ablationpancreatic tumorradiofrequency ablation (RFA)tumor ablation

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Area of Science:

  • Gastroenterology
  • Interventional Endoscopy
  • Oncology

Background:

  • Real-time needle guidance has evolved endoscopic ultrasound (EUS) into an interventional tool.
  • EUS-guided fine-needle puncture is utilized for pseudocyst drainage, biliary interventions, and drug delivery.
  • Celiac plexus neurolysis for pain management is a primary EUS-guided injection procedure.

Purpose of the Study:

  • To explore the expanded applications of EUS-guided interventions, particularly tumor ablation.
  • To highlight the advantages of EUS for minimally invasive antitumor therapy in pancreatic cancer.
  • To discuss the potential benefits for patients ineligible for surgery.

Main Methods:

  • Real-time EUS imaging for precise needle placement and agent delivery.
  • Application of techniques including radiofrequency ablation, fiducial marker placement, and delivery of antitumor agents or radioactive seeds.
  • Focus on minimally invasive EUS-guided antitumor therapy for pancreatic cancer due to anatomical access and poor prognosis.

Main Results:

  • EUS enables accurate needle positioning and precise delivery of therapeutic agents for various interventional procedures.
  • Tumor ablation using EUS is expanding, including for pancreatic cancer, neuroendocrine tumors, and cystic lesions.
  • Minimally invasive EUS-guided therapy offers a viable option for patients with pancreatic cancer who are not surgical candidates.

Conclusions:

  • EUS-guided interventions, including tumor ablation and neurolysis, significantly expand the therapeutic capabilities of endoscopy.
  • Minimally invasive EUS-guided antitumor therapy is particularly crucial for pancreatic cancer, addressing challenges in chemotherapy delivery.
  • EUS-guided ablation provides a valuable local treatment option for patients with pancreatic tumors who cannot undergo resection.