Pitfalls in interventional EUS procedures and coping strategies for endoscopy assistants (with video)

Abstract

In recent years, the application of EUS in the diagnosis and treatment has become increasingly popular due to the rapid technological advancements in this field. With the application of new technologies, EUS assistants encounter various problems or “pitfalls” during clinical operations, which may pose challenges to the successful completion of relevant procedures. For example, a needle tip may not be visualized by ultrasonography during EUS-FNA; a stiff fine needle may not be introduced through the working channel of the endoscope in the duodenum, and withdrawal of a guidewire in a needle may be associated with tearing and peeling of the guidewire in EUS-guided biliary drainage. In view of these commonly encountered problems, this article summarizes the countermeasures that EUS assistants can take for EUS-FNA and EUS-guided drainage to improve the efficiency of the procedures and reduce the occurrence of adverse events.

Mediastinal extension of a progressively enlarging pseudocyst treated by EUS-guided transgastric drainage in a child: A rare case report (with video)

“…Endoscopic cyst drainage procedures through transesophageal, transgastric, or transpapillary routes have been described in the literature. [ 3 , 4 ] However, these methods are mainly reported in the adult population, and endoscopic transmural drainage is rarely reported as a lack of expertise in the pediatric age group. It remains unclear whether the mediastinal extension of pseudocysts is more common in children than adults due to the less strong barrier of the diaphragm.…”