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Endoscopic ultrasound in the diagnosis and management ofcarcinoma pancreas

世界胃肠内镜杂志：英文版（电子版） 2016年第2期8卷 67-76页

作者： Rajesh Puri Manish Manrai ragesh babu thandassery Abdulrahman A Alfadda Institute of Digestive and Hepatobiliary Sciences MedantaThe MedicityGurgaon 122001HaryanaIndia 2Department of GastroenterologyPostgraduate Institute of Medical Education and Research Chandigarh 160012India Department of Medicine Division of GastroenterologyHamad General HospitalDoha 3050Qatar Department of Medicine Division of GastroenterologyKing Faisal Specialist Hospital and Research CenterRiyadh 12713Saudi Arabia

Endoscopic ultrasound(EUS) has become an important component in the diagnosis and treatment of carcinoma pancreas. With the advent of advanced imaging techniques and tissue acquisition methods the role of EUS is becoming increasingly important. Small pancreatic tumors can be reliably diagnosed with EUS. EUS guided fine needle aspiration establishes diagnosis in some cases. EUS plays an important role in staging of carcinoma pancreas and in some important therapeutic methods that include celiac plexus neurolysis, EUS guided biliary drainage and drug delivery. In this review we attempt to review the role of EUS in diagnosis and management of carcinoma pancreas.

关键词： Carcinoma pancreas Endoscopic ultrasound Treatment

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Endoscopic ultrasound guided liver biopsy: Recent evidence

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World Journal of Gastrointestinal Endoscopy 2020年第3期12卷 83-97页

作者： Kemmian D Johnson Passisd Laoveeravat Eric U Yee Abhilash Perisetti ragesh babu thandassery Benjamin Tharian Department of Internal Medicine Louisiana State University Health Sciences CenterNew OrleansLA 70112United States Department of Internal Medicine Texas Tech University Health Sciences CenterLubbockTX 79430United States Department of Pathology College of MedicineUniversity of Arkansas for Medical SciencesLittle RockAR 72205United States Department of Internal Medicine Division of GastroenterologyUniversity of Arkansas for Medical SciencesLittle RockAR 72205United States Department of Internal Medicine Division of GastroenterologyCentral Arkansas Veterans Health Care SystemLittle RockAR 72205United States

Liver biopsy(LB)is an essential tool in diagnosing,evaluating and managing various diseases of the liver.As such,histopathological results are critical as they establish or aid in diagnosis,provide information on prognosis,and guide the appropriate selection of medical therapy for patients.Indications for LB include evaluation of persistent elevation of liver chemistries of unclear etiology,diagnosis of chronic liver diseases such as Wilson's disease,autoimmune hepatitis,small duct primary sclerosing cholangitis,work up of fever of unknown origin,amyloidosis and more.Traditionally,methods of acquiring liver tissue have included percutaneous LB(PCLB),transjugular LB(TJLB)or biopsy taken surgically via laparotomy or laparoscopy.However,traditional methods of LB may be inferior to newer methods.Additionally,PCLB and TJLB carry higher risks of adverse events and complications.More recently,endoscopic ultrasound guided LB(EUS-LB)has evolved as an alternative method of tissue sampling that has proven to be safe and effective,with limited adverse events.Compared to PC and TJ routes,EUS-LB may also have a greater diagnostic yield of tissue,be superior for a targeted approach of focal lesions,provide higher quality images and allow for greater patient comfort.These advantages have contributed to the increased use of EUS-LB as a technique for obtaining liver tissue.Herein,we provide a review of the recent evidence of EUS-LB for liver disease.

关键词： Liver biopsy Percutaneous liver biopsy Transjugular liver biopsy Endoscopic ultrasound guided liver biopsy Fine-needle aspiration Core biopsy Fineneedle biopsy

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Endoscopic ultrasound guided drainage of pancreatic fluid collections: Assessment of the procedure, technical details and review of the literature

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World Journal of Gastrointestinal Endoscopy 2015年第4期7卷 354-363页

作者： Rajesh Puri ragesh babu thandassery Abdulrahman A Alfadda Saad Al Kaabi Institute of Digestive Hepatobiliary Sciences Medantathe MedicityGurgaonNCR Delhi 110092India Division of Gastroenterology and Hepatology Department of MedicineHamad Medical Corporation Department of Medicine King Faisal Specialist Hospital and Research Centre

Endoscopic ultrasound(EUS) guided drainage of pancreatic fluid collections(PFC) has become increasingly popular and become first line management option in many centers. Use of therapeutic echoendoscopes has greatly increased the applicability of EUS guided transmural drainage. Drainage is indicated in symptomatic PFCs, PFC related infection, bleed, luminal obstruction, fistulization and biliary obstruction. EUS guided transmural drainage of PFCs is preferred in patients with non bulging lesions, portal hypertension, bleeding tendency and in those whom conventional drainage has failed. In the present decade significant progress has been made in minimally invasive endoscopic techniques. There are newer stent designs, access devices and techniques for more efficient drainage of PFCs. In this review, we discuss the EUS guided drainage of PFCs in acute pancreatitis.

关键词： Acute pancreatitis Pancreatic fluid collections Endoscopic ultrasound-guided drainage

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Non-cirrhotic hepatocellular carcinoma in chronic viral hepatitis: Current insights and advancements

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World Journal of Gastroenterology 2021年第24期27卷 3466-3482页

作者： Abhilash Perisetti Hemant Goyal Rachana Yendala ragesh B thandassery Emmanouil Giorgakis Department of Internal Medicine Division of GastroenterologyUniversity of Arkansas for Medical SciencesLittle RockAR 72205United States Department of Internal Medicine Macon University School of MedicineMaconGA 31207United States Department of Hematology and Oncology Conway Regional Health System(CRHS)ConwayAR 72034United States Department of Gastroenterology and Hepatology Central Arkansas Veterans Healthcare SystemLittle RockAR 72205United States Department of Transplant University of Arkansas for Medical Sciences Little RockAR 72205United States

Primary liver cancers carry significant morbidity and mortality.Hepatocellular carcinoma(HCC)develops within the hepatic parenchyma and is the most common malignancy originating from the liver.Although 80%of HCCs develop within background cirrhosis,20%may arise in a non-cirrhotic milieu and are referred to non-cirrhotic-HCC(NCHCC).NCHCC is often diagnosed late due to lack of surveillance.In addition,the rising prevalence of non-alcoholic fatty liver disease and diabetes mellitus have increased the risk of developing HCC on noncirrhotic patients.Viral infections such as chronic Hepatitis B and less often chronic hepatitis C with advance fibrosis are associated with NCHCC.NCHCC individuals may have Hepatitis B core antibodies and occult HBV infection,signifying the role of Hepatitis B infection in NCHCC.Given the effectiveness of current antiviral therapies,surgical techniques and locoregional treatment options,nowadays such patients have more options and potential for cure.However,these lesions need early identification with diagnostic models and multiple surveillance strategies to improve overall outcomes.Better understanding of the NCHCC risk factors,tumorigenesis,diagnostic tools and treatment options are critical to improving prognosis and overall outcomes on these patients.In this review,we aim to discuss NCHCC epidemiology,risk factors,and pathogenesis,and elaborate on NCHCC diagnosis and treatment strategies.

关键词： Cirrhosis Hepatic fibrosis Non-alcoholic liver disease Primary liver cancer Hepatocellular carcinoma Hepatoma Liver cancer Hepatitis B virus Hepatitis C virus Liver resection Liver transplantation

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