Interventional endoscopic ultrasonography in patients with surgically altered anatomy: Techniques and literature review

Abstract

There are various reconstruction techniques that are used after upper gastrointestinal surgery. In recent years, opportunities for endoscopic diagnosis and treatment have been increasing in patients undergoing gastrointestinal surgery. With the advent of interventional endoscopic ultrasound (IV‐EUS), various procedures have been developed mainly for patients in whom endoscopic retrograde cholangiopancreatography is difficult to carry out. Indications for such procedures are expanding. IV‐EUS for surgically altered anatomy (SAA) includes EUS‐guided fine‐needle aspiration, biliary interventions (e.g. biliary drainage, treatment of bile duct stricture, removal of bile duct stones, and the rendezvous technique), and pancreatic interventions (e.g. rendezvous technique after Whipple surgery). In addition, there have been reports of various EUS‐related procedures using a forward‐viewing curved linear‐array echoendoscope that are carried out for postoperative intestinal tract reconstruction. Although interventional EUS is a useful therapeutic procedure for SAA, there are still no dedicated devices, and standardization of the procedure is warranted.

Contributions from Japan to gastrointestinal endoscopy training and development: Special report

“…Much of this progress took place in Japan. As the technology advanced, so too did the sophistication and variety of endoscopic treatment, with new techniquessuch as biopsy, polypectomy, papillotomy, laparoscopic cholecystectomy, laser endoscopy, EUS, 22,23 endoscopic surgical techniques such as EMR, ESD 24,25 and AI-assisted endoscopyappearing in rapid succession 26 .…”

Piercing technique via cholangioscopy for the reconstruction of complete anastomotic obstruction after choledochojejunostomy

“…2c,d) (Video S1). Although most CJs are treatable by BE‐ERCP or EUS‐guided procedure, 2–5 some cases require other approaches. To avoid invasive surgery, the piercing technique for cases of complete obstruction of CJs and the percutaneous route for taking the correct direction are useful.…”

Fine‐needle‐aspiration using forward‐viewing echoendoscope for the recurrence of intraductal tubulopapillary neoplasm

“…Forward‐viewing echoendoscope (FV‐EUS) has a narrow scanning field and lacks an elevator, 3 but can accurately recognize the lumen. FV‐EUS is used as an interventional endoscopic ultrasonography in patients with surgically altered anatomy 1,2,4,5 . Here, we report a case with an anastomotic pancreaticojejunostomy occlusion who underwent endoscopic ultrasound fine‐needle‐aspiration (EUS‐FNA) using a FV‐EUS for the recurrence of intraductal tubulopapillary neoplasm (ITPN).…”