The Role of EUS in the Biliary System

Frossard, Jean‐Louis; Dumonceau, Jean‐Marc

doi:10.1007/978-1-60327-480-7_14

Cited by 5 publications

(3 citation statements)

References 126 publications

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“…We recommend performing EUS-FNA of focal liver lesions accessible to EUS-FNA if: (i) a pathological result positive for malignancy would likely affect patient management, and (ii) the lesion is poorly accessible to percutaneous FNA or it is detected de novo by EUS or it has been sampled by percutaneous FNA with a nondiagnostic result (Recommendation grade C). EUS imaging of the liver is currently limited to the left lobe, the proximal part of the right lobe, the hilum, and part of the intrahepatic biliary tract, with variations related to the type of echoendoscope used and patient anatomy [127,128]. A prospective study in 41 patients who had solid liver lesions visible at EUS showed that a specimen adequate for pathological examination could be obtained in most cases (98 %) with an acceptable morbidity rate (5 %; all complications were minor) [129].…”

Section: Focal Solid Liver Lesionsmentioning

confidence: 99%

Indications, results, and clinical impact of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline

et al. 2011

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This article is part of a combined publication that expresses the current view of the European Society of Gastrointestinal Endoscopy (ESGE) about endoscopic ultrasound (EUS)-guided sampling in gastroenterology, including EUS-guided fine needle aspiration (EUS-FNA) and EUS-guided trucut biopsy (EUS-TCB), of submucosal tumors, diffuse esophageal/gastric wall thickening, pancreatic solid masses and cystic-appearing lesions, mediastinal lesions unrelated to lung or esophageal cancer, cancer of the esophagus, stomach, and rectum, lymph nodes of unknown origin, adrenal gland masses, and focal liver lesions. False-positive cytopathological results and needle tract seeding are also discussed. The present Clinical Guideline describes the results of EUS-guided sampling in the different clinical settings, considers the role of this technique in patient management, and makes recommendations on circumstances that warrant its use. A two-page executive summary of evidence statements and recommendations is provided. A separate Technical Guideline describes the general technique of EUS-guided sampling, particular techniques to maximize the diagnostic yield depending on the nature of the target lesion, and sample processing. The target readership for the Clinical Guideline mostly includes gastroenterologists, oncologists, internists, and surgeons while the Technical Guideline should be most useful to endoscopists who perform EUS-guided sampling.

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Section: Focal Solid Liver Lesionsmentioning

confidence: 99%

Indications, results, and clinical impact of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline

et al. 2011

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“…Fluoroscopic control is required for precise control of probe location. Three-dimensional IDUS (3D-IDUS) has emerged as an interesting alternative to two-dimensional IDUS [77]. Probes that allow 3D-IDUS have an immobile outer sheath and an mobile inner radial transducer; they must be connected to a specific driving unit.…”

Section: Equipment and Techniquementioning

confidence: 99%

Intraductal biliopancreatic imaging: European Society of Gastrointestinal Endoscopy (ESGE) technology review

et al. 2015

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vember 2014 using Medline (via Pubmed), the Cochrane Library, Embase, and the internet. In March 2015, a draft prepared by A. T. was sent to all group members. After agreement on a final version, the manuscript was reviewed by two members of the ESGE Governing Board and sent to all ESGE individual members for comments. It was then submitted to the journal Endoscopy for publication. This technological review was issued in 2015 and will be considered for update in 2019. Dual-operator "mother-baby" peroral cholangioscopy ! Single-operator "mother-baby" peroral cholangioscopy ! Conclusion SOC is a promising technique. Improvement of image quality and careful evaluation of costs are required before any advantage over other cholangioscopy techniques can be addressed.

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“…The interested reader is referred to technical reviews for in-depth information. 95,96 IDUS is ideally performed before biliary stenting (3D-IDUS may be recorded for interpretation by a specialist) and helps to distinguish benign from malignant strictures better than EUS, particularly for tumours at the hilum or mid-bile duct. Its accuracy for malignancy is >80% in patients with negative ERCP cytology and histology, and it may serve to guide biopsy sampling, thus improving the accuracy of histological diagnosis.…”

Section: Diagnostic Work Upmentioning

confidence: 99%

Challenging biliary strictures: pathophysiological features, differential diagnosis, diagnostic algorithms, and new clinically relevant biomarkers - part 1

Dumonceau

Delhaye

Charette

et al. 2020

Therap Adv Gastroenterol

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It is frequently challenging to make the correct diagnosis in patients with biliary strictures. This is particularly important as errors may have disastrous consequences. Benign-appearing strictures treated with stents may later be revealed to be malignant and unnecessary surgery for benign strictures carries a high morbidity rate. In the first part of the review, the essential information that clinicians need to know about diseases responsible for biliary strictures is presented, with a focus on the most recent data. Then, the characteristics and pitfalls of the methods used to make the diagnosis are summarized. These include serum biomarkers, imaging studies, and endoscopic modalities. As tissue diagnosis is the only 100% specific tool, it is described in detail, including techniques for tissue acquisition and their yields, how to prepare samples, and what to expect from the pathologist. Tricks to increase diagnostic yields are described. Clues are then presented for the differential diagnosis between primary and secondary sclerosing cholangitis, IgG4-related sclerosing cholangitis, cholangiocarcinoma, pancreatic cancer, autoimmune pancreatitis, and less frequent diseases. Finally, algorithms that will help to achieve the correct diagnosis are proposed.

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The Role of EUS in the Biliary System

Cited by 5 publications

References 126 publications

Indications, results, and clinical impact of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline

Indications, results, and clinical impact of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline

Intraductal biliopancreatic imaging: European Society of Gastrointestinal Endoscopy (ESGE) technology review

Challenging biliary strictures: pathophysiological features, differential diagnosis, diagnostic algorithms, and new clinically relevant biomarkers - part 1

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