Trevino Jessica M, Varadarajulu Shyam
Division of Gastroenterology-Hepatology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama 35294, USA.
Gastrointest Endosc. 2009 Feb;69(2):361-5. doi: 10.1016/j.gie.2008.09.021. Epub 2008 Dec 19.
The current oblique-viewing echoendoscope can occasionally be limited in its ability to perform therapeutic interventions because of the acute angle at which endoscopic accessories passed via the biopsy channel make contact with the gut wall. In an effort to overcome this limitation, a prototype forward-viewing echoendoscope was developed and successfully tested for performing transgastric drainage of pancreatic pseudocysts.
Evaluation of an initial experience with the prototype forward-viewing echoendoscope for performing interventions such as bile-duct drainage, pelvic-abscess drainage, and fiducial marker placement via the transduodenal and transrectal approaches.
A retrospective study.
An academic tertiary-referral center.
Three patients.
By using the prototype forward-viewing echoendoscope, transduodenal drainage of an obstructed bile duct, transrectal drainage of a pelvic abscess, and placement of fiducial markers in a rectal cancer were undertaken in 3 patients.
To evaluate the feasibility of performing interventions via the transduodenal and transrectal approaches by using the prototype forward-viewing echoendoscope.
The procedures were technically successful in all 3 patients, and no procedural complications were encountered. The passage of accessories and the deployment of stents were technically easy with the forward-viewing echoendoscope. In addition, there was no need to reorient the position of the echoendoscope when switching from a sonographic to endoscopic view while performing therapeutic interventions.
Small number of patients.
It was feasible to perform interventions such as drainage of an obstructive bile duct and a pelvic abscess, and placement of fiducial markers via the transduodenal and transrectal approaches by using the prototype forward-viewing echoendoscope. Further studies that include larger numbers of patients are needed to evaluate the role of the forward-viewing echoendoscope for performing EUS-guided therapeutic interventions.
目前的斜视角超声内镜在进行治疗性干预时，其能力偶尔会受到限制，因为通过活检通道的内镜附件与肠壁接触的角度很尖锐。为了克服这一限制，开发了一种原型前视超声内镜，并成功测试了其用于胰腺假性囊肿的经胃引流。
评估使用原型前视超声内镜通过经十二指肠和经直肠途径进行诸如胆管引流、盆腔脓肿引流和放置基准标记等干预的初步经验。
一项回顾性研究。
一家学术性三级转诊中心。
三名患者。
对3名患者使用原型前视超声内镜进行了梗阻性胆管的经十二指肠引流、盆腔脓肿的经直肠引流以及直肠癌的基准标记放置。
评估使用原型前视超声内镜通过经十二指肠和经直肠途径进行干预的可行性。
所有3例手术在技术上均获成功，未出现手术并发症。使用前视超声内镜时，附件的通过和支架的部署在技术上很容易。此外，在进行治疗性干预时，从超声视图切换到内镜视图时无需重新调整超声内镜的位置。
患者数量少。
使用原型前视超声内镜通过经十二指肠和经直肠途径进行诸如梗阻性胆管和盆腔脓肿引流以及放置基准标记等干预是可行的。需要进一步纳入更多患者的研究来评估前视超声内镜在进行超声内镜引导下治疗性干预中的作用。
