Department of Gastroenterology, Hepatology and Nutrition, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Endosc Ultrasound. 2015 Oct-Dec;4(4):304-11. doi: 10.4103/2303-9027.170419.
Endoscopic ultrasound (EUS) has opened new horizons in minimally invasive therapies for diverse gastrointestinal pathologies. Digestive Disease Weak 2015 held in Washington, DC., USA featured exciting research articles on EUS-guided therapeutic procedures. EUS-guided biliary drainage has been attempted and described for many years. There seems to be a lot of interest among various international groups to compare this technique with other alternatives in terms of efficacy and safety. Similarly, EUS-guided pancreatic drainage of cysts and fluid collections continues to evolve with new stents and devices being developed specifically for deployment under endosonographic guidance. EUS-guided ablation of cystic pancreatic tumors is innovative but not always effective. Combining alcohol ablation with injecting chemotherapeutic agents may improve long-term results regarding efficacy. Similarly, for solid pancreatic tumors there appears to be ongoing interest and continuing efforts in injecting different chemotherapeutic or ablative agents, delivering fiducials for radiation guidance and even attempting ablation with radiofrequency. Gastric variceal treatment and EUS-guided anastomoses also continue to be investigated. This review article is focused on the recent developments in EUS-guided therapies presented at Digestive Disease Week (DDW) 2015.
内镜超声(EUS)为多种胃肠道疾病的微创治疗开辟了新的领域。在美国华盛顿特区举行的 2015 年消化疾病周(DDW)上,有许多关于 EUS 引导治疗程序的令人兴奋的研究文章。多年来,人们一直在尝试并描述 EUS 引导下的胆道引流。许多国际团体似乎对这种技术的疗效和安全性与其他替代方法进行比较很感兴趣。同样,EUS 引导下的胰腺囊肿和积液引流也在不断发展,专门为在超声内镜引导下部署而开发的新支架和设备。EUS 引导下的胰腺囊性肿瘤消融术具有创新性,但并不总是有效。将酒精消融与注射化疗药物相结合可能会提高疗效的长期结果。同样,对于实体瘤胰腺肿瘤,人们似乎仍在持续关注并不断尝试注射不同的化疗或消融剂、为放射引导放置基准以及甚至尝试使用射频进行消融。胃静脉曲张治疗和 EUS 引导吻合术也在继续研究中。本文重点介绍了在 2015 年消化疾病周(DDW)上展示的 EUS 引导治疗的最新进展。