Endoscopic ultrasound (EUS) guided fine needle biopsy (FNB) with the Procore needle provides inadequate material for the histological diagnosis of early chronic pancreatitis

García, J. Iglesias; Lariño‐Noia, José; Abdulkader-Nallib, Ihab; Lindkvist, Björn; Domínguez‐Muñoz, J. Enrique

doi:10.17235/reed.2018.5164/2017

Cited by 5 publications

(6 citation statements)

References 23 publications

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“…A relevant pancreatic infiltration of inflammatory cells characterizes CP and, together with fibrosis, allows the histological diagnosis of the disease 26 . EUS‐guided pancreatic biopsy has been attempted to confirm the diagnosis of early CP in patients with mild EUS changes, but the authors failed at obtaining a core tissue sample adequate for histological evaluation 3 …”

Section: Discussionmentioning

confidence: 99%

“…pancreatic abnormalities associated with diabetes mellitus, aging or smoking). Histological diagnosis of early CP is nowadays unfeasible, and accurate biomarkers are still lacking 3 . Demonstration of combined mild morphological and functional abnormalities in the appropriate clinical context by using sensitive methods could nowadays be used to support the clinical suspicion of early CP.…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic ultrasound‐based multimodal evaluation of the pancreas in patients with suspected early chronic pancreatitis

et al. 2020

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Background Diagnosis of early chronic pancreatitis is a clinical challenge and hindered by the lack of a gold standard. Endoscopic ultrasound (EUS) and the endoscopic pancreatic function test (ePFT) are the most sensitive morphological and functional methods in this setting. EUS-elastography allows for the quantification (strain ratio) of pancreatic fibrosis, and the dynamic evaluation of the main pancreatic duct compliance provides additional information. We developed a multimodal EUS-based approach for the evaluation of the pancreas by integrating these four methods in a single procedure. Objective We aim to describe morphological and functional pancreatic abnormalities in patients with clinical suspicion of chronic pancreatitis and inconclusive EUS findings by using the multimodal EUS-based approach. Methods This was a prospective, cross-sectional, observational study of patients with clinically suspected chronic pancreatitis and indeterminate EUS criteria of the disease. EUS criteria of chronic pancreatitis, quantitative pancreatic elastography, ePFT and compliance of the main pancreatic duct were evaluated in a single procedure. Results In total, 53 patients with 3–4 EUS criteria of chronic pancreatitis were included (mean age 39.7 years, 29 male). Strain ratio was abnormally high in all patients. Peak bicarbonate concentration was decreased in 43 patients (81.1%) and the main pancreatic duct compliance was reduced in 41 patients (77.3%). Some 34 patients (64.1%) had abnormal results at EUS, elastography, ePFT and compliance of the main pancreatic duct. Conclusions A multimodal EUS-based test for the morphological and functional evaluation of the pancreas is presented, which allows detecting mild pancreatic abnormalities in patients with suspected early chronic pancreatitis. The presence of abnormal morphological and functional evaluation of the pancreas could support the clinical suspicion of early chronic pancreatitis in the appropriate clinical setting.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Endoscopic ultrasound‐based multimodal evaluation of the pancreas in patients with suspected early chronic pancreatitis

et al. 2020

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“…If a significant dilation of the pancreatic duct is seen, an obstructive process should be excluded (like pancreatic head formations, ampullary process, bile duct disease). In case of duct dilation, an IPMN should also be taken into account for differential diagnosis, and care should be taken to visualize small polypoid structures originating from the ducts’ walls [75, 76].…”

Section: Eus For the Diagnosis Of Chronic Pancreatitismentioning

confidence: 99%

“…In one study which compared EUS elastography with histology, a strain ratio cut-off of 2.25 yielded an accuracy of 91% [78] and predicted pancreatic exocrine insufficiency [79]. EUS-guided biopsy for histological diagnosis of early chronic pancreatitis has a low diagnostic yield and a non-negligible risk of complication, so it is not suggested for the workup of chronic pancreatitis [75].…”

Section: Eus For the Diagnosis Of Chronic Pancreatitismentioning

confidence: 99%

Endoscopic Ultrasound in Pancreatology: Focus on Inflammatory Diseases and Interventions

Vitali,

Zundler,

Jesper

et al. 2023

Visc Med

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Background: Endoscopic ultrasound (EUS) is a main tool in pancreatology for both diagnosis and therapy. It allows minimally invasive differentiation of various diseases, with a minimal degree of inflammation or anatomic variations. EUS also enables interventional direct access to the pancreatic parenchyma and the retroperitoneal space, the pancreatic duct, the pancreatic masses, cysts, vascular structures for diagnostic and therapeutic purposes. Summary: This review aimed to summarize the new developments of EUS in the field of pancreatology, with special interest on inflammation and interventions. EUS enables way to perform pseudocyst drainage, necrosectomy, transenteral drainage and transenteric access of the main pancreatic duct, or the direct visualization or therapy of vascular structures adjacent to the pancreas. Key Messages: EUS has a deep impact on pancreatology, and the development of new diagnostic and interventional approaches to the retroperitoneal space and the pancreas has increased in the last years exponentially, allowing minimal invasive diagnostics and therapy and avoiding surgery and percutaneous therapy.

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“…1 In addition to its diagnostic applications, EUS has therapeutic uses as well. [2][3][4][5][6] Interventional EUS (IEUS) procedures include drainage of pancreatic pseudocysts, celiac plexus neurolysis for pain management, and stenting of biliary and GI strictures. 7 EUS-guided gastrojejunostomy and gastroenterostomy are emerging minimally invasive techniques for managing patients with malignant and benign upper GI tract obstruction that have demonstrated high technical success rates.…”

Section: Introductionmentioning

confidence: 99%

Impact and assessment of training models in interventional endoscopic ultrasound

Miutescu,

Dhir

2023

Digestive Endoscopy

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Interventional endoscopic ultrasound (IEUS) has gained significant popularity in recent years because of its diagnostic and therapeutic capabilities. The proper training of endoscopists is critical to ensure safe and effective procedures. This review study aims to assess the impact of different training models on the competence of trainees performing IEUS. Eight studies that evaluated simulators for IEUS were identified in the medical literature. Various training models have been used, including the EASIE‐R, Mumbai EUS, EUS Magic Box, EndoSim, Thai Association for Gastrointestinal Endoscopy model, and an ex vivo porcine model (HiFi SAM). The trainees underwent traditional didactic lectures, hands‐on training using simulators, and direct supervision by experienced endoscopists. The effectiveness of these models has been evaluated based on objective and subjective parameters such as technical proficiency, operative time, diagnostic success, and participant feedback. As expected, the majority of skills were improved after the training sessions concluded, although the risk of bias is high in the absence of external validation. It is difficult to determine the ideal simulator among the existing ones because of the wide variation between them in terms of costs, reusability, design, fidelity of anatomical structures and feedback, and types of procedures performed. There is a need for a standardized approach for the evaluation of IEUS simulators and the ways skills are acquired by trainees, as well as a clearer definition of the key personal attributes necessary for developing a physician into a skilled endoscopist capable of performing basic and advanced therapeutic EUS interventions.

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Endoscopic ultrasound (EUS) guided fine needle biopsy (FNB) with the Procore needle provides inadequate material for the histological diagnosis of early chronic pancreatitis

Cited by 5 publications

References 23 publications

Endoscopic ultrasound‐based multimodal evaluation of the pancreas in patients with suspected early chronic pancreatitis

Endoscopic ultrasound‐based multimodal evaluation of the pancreas in patients with suspected early chronic pancreatitis

Endoscopic Ultrasound in Pancreatology: Focus on Inflammatory Diseases and Interventions

Impact and assessment of training models in interventional endoscopic ultrasound

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Endoscopic ultrasound (EUS) guided fine needle biopsy (FNB) with the Procore needle provides inadequate material for the histological diagnosis of early chronic pancreatitis

Cited by 5 publications

References 23 publications

Endoscopic ultrasound‐based multimodal evaluation of the pancreas in patients with suspected early chronic pancreatitis

Endoscopic ultrasound‐based multimodal evaluation of the pancreas in patients with suspected early chronic pancreatitis

Endoscopic Ultrasound in Pancreatology: Focus on Inflammatory Diseases and Interventions

Impact and assessment of training models in interventional endoscopic ultrasound

Contact Info

Product

Resources

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Endoscopic ultrasound (EUS) guided fine needle biopsy (FNB) with the Procore needle provides inadequate material for the histological diagnosis of early chronic pancreatitis