Accuracy of Endoscopic Ultrasound Imaging in Distinguishing Celiac Ganglia From Celiac Lymph Nodes

Malikowski, Thomas; Lehrke, Heidi D.; Henry, Michael R.; Gleeson, Ferga C.; Topazian, Mark D.; Harmsen, William S.; Takahashi, Naoki; Inoue, Dai; Gara, Naveen; Dayyeh, Barham K. Abu; Chari, Suresh T.; Iyer, Prasad G.; Rajan, Elizabeth; Wang, Kenneth K.; Levy, Michael J.

doi:10.1016/j.cgh.2018.05.025

Cited by 6 publications

(2 citation statements)

References 20 publications

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“…The neurolytic agent can be injected centrally at the base of the coeliac axis, bilaterally or directly into the coeliac ganglia. [72126] The coeliac ganglia can reliably be identified by EUS[127] and selectively targeted for ethanol injection. However, the injected ethanol spreads beyond the targeted ganglion and high volume ethanol injection for diffuse coeliac plexus neurolysis is more likely to also reach unidentified ganglia.…”

Section: Coeliac Blockmentioning

confidence: 99%

Therapeutic EUS: New tools, new devices, new applications

2019

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Linear echoendoscopes with large instrument channels enable EUS-guided interventions in organs and anatomical spaces in proximity to the gastrointestinal tract. Novel devices and tools designed for EUS-guided transluminal interventions allow various new applications and improve the efficacy and safety of these procedures. New-generation biopsy needles provide higher histology rates and require less passes. Specially designed stents and stent insertion devices enable intra- and extra-hepatic bile and pancreatic duct stenting as well as gallbladder drainage. Currently, EUS-guided biliary drainage in obstructive jaundice due to malignant distal bile duct obstruction is feasible and safe when ERCP has failed. It might replace ERCP as first choice intervention in future. EUS-guided transmural stenting is regarded as the preferred intervention in the management of symptomatic peripancreatic fluid collections. Creating a new anastomosis between different organs such as gastrojejunostomy has also become possible with lumen-apposing stents. EUS-guided creation of a gastrogastrostomy is a promising novel technique to access the excluded stomach to facilitate conventional ERCP in patients with Roux-en-Y gastric bypass anatomy. The role of EUS in tumor ablation and targeted angiotherapy is also constantly expanding. In this review, we report on the newest developments of therapeutic EUS within the past 4 years.

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Section: Coeliac Blockmentioning

confidence: 99%

Therapeutic EUS: New tools, new devices, new applications

2019

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“…Lymph Nodes E ndoscopic ultrasound allows visualization of celiac lymph nodes and celiac ganglia, but it is important to reliably distinguish these 2 structures as part of tumor staging and treatment. In a study of 504 patients, and using cytopathology as the reference standard, Malikowski and colleagues 8 found that endoscopic ultrasound accurately identified 98.3% of celiac lymph nodes and 89.2% of celiac ganglia, with an overall accuracy of 94.7%. These findings support the use of endoscopic ultrasound for enhancing clinical tumor staging accuracy, for administering stage appropriate therapy, and to help to guide the development of new clinical and therapeutic celiac ganglia applications.…”

Section: Accuracy Of Endoscopic Ultrasound Imaging In Distinguishing mentioning

confidence: 99%