Consensus guidelines on the optimal management in interventional EUS procedures: results from the Asian EUS group...

Area of Science:

• Gastroenterology and Endoscopy
• Interventional Radiology
• Surgical Oncology

Background:

• Interventional endoscopic ultrasonography (EUS) procedures are increasingly common.
• Key procedures include EUS-guided drainage of pancreatic pseudocyst, biliary, and pancreatic ducts, and celiac plexus ablation.

Purpose of the Study:

• To formulate practice guidelines for common interventional EUS procedures.
• To address indications, technical aspects, management, and training for these procedures.

Main Methods:

• Utilized the RAND/UCLA appropriateness methodology (RAM).
• Convened a panel of international experts in surgery, interventional EUS, radiology, and oncology.
• Conducted meetings between June 2014 and October 2016 to discuss and vote on clinical scenarios.

Main Results:

• Developed 15 statements for EUS-guided pancreatic pseudocyst drainage, 15 for biliary drainage, 12 for pancreatic duct drainage, and 14 for celiac plexus ablation.
• Statements covered indications, technical aspects, pre/post-procedural management, complication management, and training.
• All but one statement were deemed appropriate, highlighting the need for further randomized studies.

Conclusions:

• These are the first guidelines for interventional EUS procedures published by an endoscopic society.
• The guidelines offer an in-depth review of current evidence.
• They aim to standardize the management of interventional EUS procedures.