The Role of Endoscopic Ultrasound in Pancreatic Pathologies: A Prospective Study

The onbejctive of the study is to assess the effectiveness of endoscopic ultrasound (EUS) as a diagnostic and therapeutic modality in the management of pancreatic disorders, including chronic pancreatitis, cystic and solid lesions, and suspected malignancies.

A prospective study was conducted over 18 months at a tertiary care hospital. Patients presenting with clinical or radiological suspicion of pancreatic disorders were included after obtaining informed consent. EUS was utilized for detailed morphological evaluation, lesion characterization, tissue acquisition for histological analysis, and cancer staging. Therapeutic procedures included EUS-guided pseudocyst drainage, celiac plexus block (CPB), and pancreatic duct stenting. Primary outcomes were diagnostic yield, accuracy of lesion evaluation, and the success of therapeutic procedures, determined by symptom relief and reduced need for further interventions.

Among 63 patients evaluated, EUS diagnosed chronic pancreatitis and its variants in 23.8% and identified 18 solid and six cystic pancreatic lesions. EUS-guided fine-needle aspiration demonstrated histological concordance in 79.2% of solid lesions. Therapeutic EUS was performed in 16 cases, all with successful technical outcomes. Interventions, particularly pseudocyst drainage and CPB, led to meaningful symptom relief. No immediate or delayed procedure-related complications were recorded. Disease recurrence during follow-up was observed in 2 patients (3.2%).

EUS proved to be an effective and safe modality for the diagnosis and management of various pancreatic conditions. Its integration into routine clinical practices may reduce reliance on invasive surgery and improve patient outcomes.