Rizzatti Gianenrico, Larghi Alberto
Unità di Endoscopia Digestiva, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma.
Recenti Prog Med. 2021 Jan;112(1):54-57. doi: 10.1701/3525.35124.
Endoscopic ultrasound (EUS) is rapidly evolving from a diagnostic into a mainly therapeutic procedure, similarly to what previously occurred to endoscopic retrograde cholangio-pancreatography (ERCP). The capability to easily access adjacent organs and structures with a minimally invasive approach as well as the availability of dedicated devices are driving this process. Several therapeutic procedures can be performed under EUS-guidance, such as drainage of pancreatic fluid collections, of the biliary system after ERCP failure, of the gallbladder for acute cholecystitis in high-risk surgical patients, as well as endoscopic gastroenteral-anastomosis creation. The introduction of dedicated lumen-apposing metal stents in the latest years has made these procedures technically easier. However, further improvements of stent design will be required in the next future. Moreover, data on long-term efficacy and safety coming from well-designed randomized multicenter controlled trials are still needed to bring EUS-guided procedures to the next level.
内镜超声（EUS）正在迅速从一种诊断性检查发展成为一种主要的治疗手段，这与之前内镜逆行胰胆管造影（ERCP）的发展情况类似。通过微创方法轻松进入相邻器官和结构的能力以及专用设备的可用性推动了这一进程。在EUS引导下可以进行多种治疗程序，例如胰腺液体积聚引流、ERCP失败后胆道系统引流、高危手术患者急性胆囊炎时胆囊引流以及内镜胃肠吻合术的创建。近年来专用的管腔贴合金属支架的引入使这些程序在技术上变得更加容易。然而，在未来还需要对支架设计进行进一步改进。此外，仍需要来自精心设计的随机多中心对照试验的关于长期疗效和安全性的数据，以使EUS引导的程序提升到更高水平。
