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Abstract and Introduction
Abstract
Endoscopic ultrasound, which was developed more than 20 years ago, is currently a valuable investigative tool for endoscopists. It began as a diagnostic instrument and in the short span of a decade made a clinical impact as a therapeutic tool with a promising potential for various interventional applications. The introduction of the curved linear array echoendoscope in the 1990s enabled a whole range of interventional applications of endoscopic ultrasound ranging from fine needle aspiration of lesions surrounding the gastrointestinal tract to celiac plexus block and drainage of pancreatic pseudocyst. This review article outlines the current interventional applications of endoscopic ultrasound and discusses potential future procedures. These procedures include endoscopic ultrasound guided creation of communication between the gastrointestinal tract and adjacent organs, such as hepaticogastrostomy and choledochoduodenostomy.
Introduction
Since its advent more than 20 years ago, endoscopic ultrasound (EUS) has undergone evolution from an experimental to a diagnostic instrument and is now established as a therapeutic tool for endoscopists.
Endoscopic ultrasound provides clear imaging of intramural and extramural structures in the abdomen and mediastinum. However, it cannot accurately distinguish benign from malignant changes in the primary lesion or lymph node on imaging alone. With the introduction of the curved linear array echoendoscope in the 1990s, the indications for EUS have expanded. The curved linear array echoendoscope enables the visualization of a needle as it exits from the biopsy channel in the same plane of ultrasound imaging in real time. This allows the endoscopist to perform a whole range of interventional applications ranging from fine needle aspiration (FNA) of lesions surrounding the gastrointestinal tract to celiac plexus block and drainage of pancreatic pseudocyst. This article reviews the current interventional application of EUS.
Review Methodology of Published Studies
Papers involving interventional EUS were sought by searching MEDLINE prior to October 2004 using the keywords: EUS, endosonography, cytology, fine needle aspiration, trucut, complication and intervention.
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