The ERCP room can range from very basic to state-of-the-art. Whereas smaller institutions with low ERCP volumes often perform ERCP in the radiology department or operating room, most centers with a larger ERCP volumes perform ERCP in dedicated rooms within…
Endoscopic retrograde cholangiopancreatography (ERCP) has been a remarkable technological advance that has evolved over its nearly 50 years in the field of gastrointestinal endoscopy and has redefined the medical and surgical approach to patients with pancreatic and biliary tract diseases.…
Key points Endo-hepatology has emerged as a new subspecialty in GI endoscopy, leveraging the strength of endoscopy and EUS in the diagnosis, prognosis, and treatment of patients with liver disease. EUS-shear-wave elastography (SWE) can quantitatively assess liver stiffness in both…
Key points EUS-guided glue-coil therapy is a safe and effective method for treatment of or primary prophylaxis for gastric variceal bleeding. Combining coil implantation with glue injection is more effective than monotherapy. Attention should be paid to the varied polymerization…
Key points EUS-guided pancreatic chemoablation has emerged as an innovative, promising, and minimally invasive approach for the treatment of appropriately selected neoplastic type pancreatic cysts. When performed at expert centers, the treatment response appears durable in majority of patients at…
Key points An anastomosis can be established between the stomach and the jejunum under endoscopic ultrasound (EUS)-guidance in patients with gastric outlet obstruction. A lumen-apposing metal stent (LAMS) can be deployed either directly or via assisted-techniques using fluoroscopic and sonographic…
Key points Endoscopic ultrasonography (EUS)-guided celiac plexus interventions consist of the injection of neurolytic agents or steroids into ganglia to produce neurolysis or temporary block. Celiac plexus block or neurolysis is the most common EUS-guided intervention in current practice. Significant…
Key points In patients who are unfit for surgery, percutaneous drainage, endoscopic transpapillary drainage and EUS-guided drainage are all effective and safe alternative procedures to cholecystectomy EUS-guided drainage is preferred over percutaneous technique due to similar rates of technical success…
Key points Endoscopic ultrasonography-guided biliary drainage (EUS-BD) is now generally preferred over percutaneous methods in patients with biliary obstruction and failed biliary cannulation during endoscopic retrograde cholangiopancreatography (ERCP), and should be considered in those with an inaccessible papilla. EUS-BD is…
Key points Recognition of different types of pancreatic fluid collections is crucial for appropriate management. EUS-guided drainage is the treatment of choice in the management of pancreatic pseudocysts, with clinical outcomes comparable to surgical cystogastrostomy. The management of walled-off necrosis…