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Comparison of diagnostic performances of slow-pull suction and standard suction in endoscopic ultrasound-guided fine needle biopsy for gastrointestinal subepithelial tumors
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Joon Seop Lee, Chang Min Cho, Yong Hwan Kwon, An Na Seo, Han Ik Bae, Man-Hoon Han
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Clin Endosc 2022;55(5):637-644. Published online August 17, 2022
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DOI: https://doi.org/10.5946/ce.2021.257
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 Abstract
 PDF PubReader ePub
- Background
/Aims: Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) is integral to the diagnosis of gastrointestinal (GI) subepithelial tumors (SETs). The impact of different EUS-FNB tissue sampling techniques on specimen adequacy and diagnostic accuracy in SETs has not been fully evaluated. This study aimed to compare the diagnostic outcomes of slow-pull (SP) and standard suction (SS) in patients with GI SETs.
Methods
In this retrospective comparative study, 54 patients were enrolled. Medical records were reviewed for location and size of the target lesion, FNB needle type/size, technical order, specimen adequacy, diagnostic yield, and adverse events. The acquisition rate of adequate specimens and diagnostic accuracy were compared according to EUS-FNB techniques.
Results
The mean lesion size was 42.6±36.4 mm, and most patients were diagnosed with GI stromal tumor (75.9%). The overall diagnostic accuracies of the SP and SS techniques were 83.3% and 81.5%, respectively (p=0.800). The rates of obtaining adequate core tissue were 79.6% and 75.9%, respectively (p=0.799). No significant clinical factors affected the rate of obtaining adequate core tissue, including lesion location and size, FNB needle size, and final diagnosis.
Conclusions
SP and SS had comparable diagnostic accuracies and adequate core tissue acquisition for GI SETs via EUS-FNB.
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Citations
Citations to this article as recorded by  - Advancements in endoscopic resection of subepithelial tumors: toward safer, recurrence-free techniques
Won Shik Kim, Moon Kyung Joo
Clinical Endoscopy.2025; 58(2): 256. CrossRef - Endoscopic ultrasound-guided fine-needle aspiration for gastrointestinal subepithelial lesions
Takuto Hikichi, Minami Hashimoto, Takumi Yanagita, Tsunetaka Kato, Jun Nakamura
Journal of Medical Ultrasonics.2024; 51(2): 195. CrossRef - What method can we choose if rapid on-site evaluation is not available for the endoscopic ultrasound-guided tissue acquisition of upper gastrointestinal subepithelial lesions?
Yu Kyung Cho
Clinical Endoscopy.2024; 57(1): 53. CrossRef - The Diagnostic Approach of Benign Esophageal Tumors: A Narrative Review
Alex R. Jones, Preksha Vankawala, Tarek Sawas
Current Treatment Options in Gastroenterology.2024; 22(2): 44. CrossRef - Diagnostic yield of endoscopic and EUS-guided biopsy techniques in subepithelial lesions of the upper GI tract: a systematic review
Cynthia A. Verloop, Jacqueline A.C. Goos, Marco J. Bruno, Rutger Quispel, Lydi M.J.W. van Driel, Lieke Hol
Gastrointestinal Endoscopy.2024; 99(6): 895. CrossRef - EUS‐guided tissue acquisition from gastric subepithelial lesions—The optimal technique still remains undecided
Suprabhat Giri, Sridhar Sundaram
Australasian Journal of Ultrasound in Medicine.2024; 27(4): 263. CrossRef - An Esophageal Leiomyoma with Cystic Degeneration Mimicking a Malignant Neoplasm
Gwang Ha Kim, Dong Chan Joo, Moon Won Lee, Bong Eun Lee, Kyungbin Kim
The Ewha Medical Journal.2023;[Epub] CrossRef - Prevalence, natural progression, and clinical practices of upper gastrointestinal subepithelial lesions in Korea: a multicenter study
Younghee Choe, Yu Kyung Cho, Gwang Ha Kim, Jun-Ho Choi, Eun Soo Kim, Ji Hyun Kim, Eun Kwang Choi, Tae Hyeon Kim, Seong-Hun Kim, Do Hoon Kim
Clinical Endoscopy.2023; 56(6): 744. CrossRef
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Biliary Self-Expandable Metal Stent Could Be Recommended as a First Treatment Modality for Immediate Refractory Post-Endoscopic Retrograde Cholangiopancreatography Bleeding
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Sun Young Moon, Jun Heo, Min Kyu Jung, Chang Min Cho
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Clin Endosc 2022;55(1):128-135. Published online May 25, 2021
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DOI: https://doi.org/10.5946/ce.2021.057
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Abstract
PDFPubReaderePub
- Background
/Aims: Recent reports suggest that the biliary self-expandable metallic stent (SEMS) is highly effective for maintaining hemostasis when endoscopic hemostasis fails in endoscopic retrograde cholangiopancreatography (ERCP)-related bleeding. We compared whether temporary SEMS offers better efficacy than angioembolization for refractory immediate ERCP-related bleeding.
Methods
Patients who underwent SEMS placement or underwent angioembolization for bleeding control in refractory immediate ERCP-related bleeding were included in the retrospective analysis. We evaluated the hemostasis success rate, severity of bleeding, change in hemoglobin levels, amount of transfusion, and delay to the start of hemostasis.
Results
A total of 27 patients with SEMS and 13 patients who underwent angioembolization were enrolled. More transfusions were needed in the angioembolization group (1.0±1.4 units vs. 2.5±2.0 units; p=0.034). SEMS failure was successfully rescued by angioembolization. The partially covered SEMS (n=23, 85.1%) was generally used, and the median stent-indwelling time was 4 days. The mean delay to the start of angioembolization was 95.2±142.9 (range, 9–491) min.
Conclusions
Temporary SEMS had similar results to those of angioembolization (96.3% vs. 92.3%; p=0.588). Immediate SEMS insertion is considered a bridge treatment modality for immediate refractory ERCP-related bleeding. Angioembolization still has a role as rescue therapy when SEMS does not work effectively.
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Clinical and Technical Guideline for Endoscopic Ultrasound (EUS)-Guided Tissue Acquisition of Pancreatic Solid Tumor: Korean Society of Gastrointestinal Endoscopy (KSGE)
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Moon Jae Chung, Se Woo Park, Seong-Hun Kim, Chang Min Cho, Jun-Ho Choi, Eun Kwang Choi, Tae Hoon Lee, Eunae Cho, Jun Kyu Lee, Tae Jun Song, Jae Min Lee, Jun Hyuk Son, Jin Suk Park, Chi Hyuk Oh, Dong-Ah Park, Jeong-Sik Byeon, Soo Teik Lee, Ho Gak Kim, Hoon Jai Chun, Ho Soon Choi, Chan Guk Park, Joo Young Cho
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Clin Endosc 2021;54(2):161-181. Published online March 24, 2021
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DOI: https://doi.org/10.5946/ce.2021.069
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Abstract
PDFPubReaderePub
- Endoscopic ultrasound (EUS)-guided tissue acquisition of pancreatic solid tumor requires a strict recommendation for its proper use in clinical practice because of its technical difficulty and invasiveness. The Korean Society of Gastrointestinal Endoscopy (KSGE) appointed a Task Force to draft clinical practice guidelines for EUS-guided tissue acquisition of pancreatic solid tumor. The strength of recommendation and the level of evidence for each statement were graded according to the Minds Handbook for Clinical Practice Guideline Development 2014. The committee, comprising a development panel of 16 endosonographers and an expert on guideline development methodology, developed 12 evidence-based recommendations in 8 categories intended to help physicians make evidence-based clinical judgments with regard to the diagnosis of pancreatic solid tumor. This clinical practice guideline discusses EUS-guided sampling in pancreatic solid tumor and makes recommendations on circumstances that warrant its use, technical issues related to maximizing the diagnostic yield (e.g., needle type, needle diameter, adequate number of needle passes, sample obtaining techniques, and methods of specimen processing), adverse events of EUS-guided tissue acquisition, and learning-related issues. This guideline was reviewed by external experts and suggests best practices recommended based on the evidence available at the time of preparation. This guideline may not be applicable for all clinical situations and should be interpreted in light of specific situations and the availability of resources. It will be revised as necessary to cover progress and changes in technology and evidence from clinical practice.
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Citations
Citations to this article as recorded by - Role of Endoscopic Ultrasound in the Management of Pancreatic Cancer
Balaji Musunuri, Shiran Shetty
Indian Journal of Surgical Oncology.2024; 15(S2): 269. CrossRef - Endoscopic Ultrasound (EUS) guided biopsy of healthy pig pancreas: Towards the histological diagnosis of chronic pancreatitis.
Julio Iglesias-García, Yessica Domínguez-Novoa, Héctor Lazare-Iglesias, Antonio González-Cantalapiedra, Ihab Abdulkader-Nallib, Óscar Varela-López, José Lariño-Noia, Enrique Domínguez-Muñoz
Revista Española de Enfermedades Digestivas.2024;[Epub] CrossRef - Endoscopic ultrasound-guided tissue acquisition for personalized treatment in pancreatic adenocarcinoma
Sang Myung Woo
Clinical Endoscopy.2023; 56(2): 183. CrossRef - Pancreatic duct lavage cytology combined with a cell-block method for patients with possible pancreatic ductal adenocarcinomas, including pancreatic carcinoma in situ
Hiroaki Kusunose, Shinsuke Koshita, Yoshihide Kanno, Takahisa Ogawa, Toshitaka Sakai, Keisuke Yonamine, Kazuaki Miyamoto, Fumisato Kozakai, Hideyuki Anan, Kazuki Endo, Haruka Okano, Masaya Oikawa, Takashi Tsuchiya, Takashi Sawai, Yutaka Noda, Kei Ito
Clinical Endoscopy.2023; 56(3): 353. CrossRef - Anesthesia care provider sedation versus conscious sedation for endoscopic ultrasound–guided tissue acquisition: a retrospective cohort study
Sneha Shaha, Yinglin Gao, Jiahao Peng, Kendrick Che, John J. Kim, Wasseem Skef
Clinical Endoscopy.2023; 56(5): 658. CrossRef - Endoscopic ultrasound-guided tissue acquisition and gene panel testing for pancreatic cancer
Kentaro SUDO, Emiri KITA, Akiko TSUJIMOTO, Kazuyoshi NAKAMURA, Akiko ODAKA, Makiko ITAMI, Sana YOKOI, Hiroshi ISHII
Suizo.2022; 37(1): 8. CrossRef - Impact of rapid on-site evaluation on diagnostic accuracy of EUS-guided fine-needle aspiration of solid pancreatic lesions: experience from a single center
Irem Guvendir, Itir Ebru Zemheri, Kamil Ozdil
BMC Gastroenterology.2022;[Epub] CrossRef - Endoscopic Ultrasound Guided Fine Needle Aspiration and Biopsy for Pancreatic Disease
Kwang Hyuck Lee
The Korean Journal of Pancreas and Biliary Tract.2021; 26(4): 241. CrossRef
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Comparison of Clinical Outcomes between Plastic Stent and Novel Lumen-apposing Metal Stent for Endoscopic Ultrasound-Guided Drainage of Peripancreatic Fluid Collections
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Ho Cheol Shin, Chang Min Cho, Min Kyu Jung, Seong Jae Yeo
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Clin Endosc 2019;52(4):353-359. Published online March 13, 2019
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DOI: https://doi.org/10.5946/ce.2018.154
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Abstract
PDFPubReaderePub
- Background
/Aims: Endoscopic ultrasound (EUS)-guided transmural drainage for peripancreatic fluid collections (PFCs) has gained wide acceptance as a nonsurgical intervention. Although a lumen-apposing metal stent (LAMS) was recently introduced, there are few data comparing the clinical outcomes between LAMS and plastic stent (PS) drainage.
Methods
Endoscopy databases of all patients who had undergone EUS-guided drainage for PFCs were searched and the clinical outcomes of EUS-guided drainage according to stent-type used were compared.
Results
A total of 27 patients (median age, 56 years) with PFCs underwent EUS-guided transmural drainage between January 2011 and December 2017. Of these, 17 underwent PS placement and 10 underwent LAMS placement. There was no significant difference in the technical success rate between the 2 groups (94.1% vs. 100%, p=1.0). Procedure time was shorter in the LAMS group compared to that in the PS group (10.6±2.5 min vs. 21.4±9.5 min, p=0.002). Among subjects with clinical success, recurrence of PFC after stent removal occurred in 5 of 12 patients with PS and 4 of 10 with LAMS, without statistical difference (41.7% vs. 40.0%, p=1.0).
Conclusions
Although our study showed similar clinical outcomes for LAMS and PS, further prospective trials are required to validate the superiority of LAMS.
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Citations
Citations to this article as recorded by - Safety and efficacy of lumen-apposing metal stents for endoscopic ultrasound-guided drainage of pancreatic fluid collections: a systematic review and meta-analysis
Vishnu Charan Suresh Kumar, Sahib Singh, Vishali Moond, Babu P. Mohan, Ganesh Aswath, Hafiz M. A. Khan, Bishnu Sapkota, Douglas G. Adler
Endoscopy.2025; 57(03): 282. CrossRef - Efficacy and safety of long-term indwelling plastic stents after resolution of pancreatic fluid collections with endoscopic transmural drainage: a systematic review and meta-analysis
Fadi Hawa, Jean M. Chalhoub, Ana Vilela, Elit Quingalahua, Carol Shannon, George M. Philips, Richard S. Kwon, Erik-Jan Wamsteker, Allison R. Schulman, Matthew J. DiMagno, Jorge D. Machicado
Surgical Endoscopy.2024; 38(5): 2350. CrossRef - Multicenter study of the efficacy and safety of electrocautery-enhanced lumen-apposing metal stents for the internal drainage of pancreatic fluid collections
Chen-Shuan Chung, Yu-Ting Kuo, Yi-Chun Chiu, Yang-Chao Lin, Chi-Ying Yang, Kuan-Chih Chen, Szu-Chia Liao, Cheuk-Kay Sun, Yen-Chih Lin, Hsiu-Po Wang
Scientific Reports.2024;[Epub] CrossRef - Endoscopic management of pancreatic collections. Endoscopic Ultrasound Group from the Spanish Society of Digestive Endoscopy (GSEED-USE) Clinical Guidelines
Mariano González-Haba Ruiz, María Teresa Betés Ibáñez, Belén Martínez Moreno , Alejandro Repiso Ortega, Carlos de la Serna Higuera, Julio Iglesias García, Oriol Sendino García, María Moris Felgueroso, Belén Agudo Castillo, José Miguel Esteban Lóp
Revista Española de Enfermedades Digestivas.2024;[Epub] CrossRef - Endoscopic ultrasound-guided pancreatic fluid collection drainage: Where are we?
Anupam Kumar Singh, Manish Manrai, Rakesh Kochhar
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Faisal Kamal, Muhammad Aziz, Wade Lee-Smith, Sachit Sharma, Ashu Acharya, Muhammad Ali Khan, Umer Farooq, Zahid Ijaz Tarar, Manesh Kumar Gangwani, Umar Hayat, Anand Kumar, Alexander Schlacterman, Thomas Kowalski, Douglas G. Adler
Digestive Diseases and Sciences.2024; 69(9): 3466. CrossRef - Head‐to‐head comparison between endoscopic ultrasound guided lumen apposing metal stent and plastic stents for the treatment of pancreatic fluid collections: A systematic review and meta‐analysis
Edson Guzmán‐Calderón, Alfonso Chacaltana, Ramiro Díaz, Bruno Li, Belen Martinez‐Moreno, José Ramón Aparicio
Journal of Hepato-Biliary-Pancreatic Sciences.2022; 29(2): 198. CrossRef - JPNclinical practice guidelines 2021 with easy‐to‐understand explanations for the management of acute pancreatitis
Tadahiro Takada, Shuji Isaji, Toshihiko Mayumi, Masahiro Yoshida, Yoshifumi Takeyama, Takao Itoi, Keiji Sano, Yusuke Iizawa, Atsushi Masamune, Morihisa Hirota, Kohji Okamoto, Dai Inoue, Nobuya Kitamura, Yasuhisa Mori, Shuntaro Mukai, Seiki Kiriyama, Kunih
Journal of Hepato-Biliary-Pancreatic Sciences.2022; 29(10): 1057. CrossRef - Comparison Between Lumen-Apposing Metal Stents and Plastic Stents in Endoscopic Ultrasound–Guided Drainage of Pancreatic Fluid Collection
Yunxiao Lyu, Ting Li, Bin Wang, Yunxiao Cheng, Liang Chen, Sicong Zhao
Pancreas.2021; 50(4): 571. CrossRef - Current status of treatments of pancreatic and peripancreatic collections of acute pancreatitis
Nian-Jun Xiao, Ting-Ting Cui, Fang Liu, Wen Li
World Journal of Gastrointestinal Surgery.2021; 13(7): 633. CrossRef - Current treatment of pancreatic pseudocysts: a systematic review
V. M. Durleshter, S. R. Genrikh, A. V. Makarenko, D. S. Kirakosyan
Kuban Scientific Medical Bulletin.2021; 28(4): 85. CrossRef - Metal Versus Plastic Stents for Pancreatic Fluid Collection Drainage
Xianzhu Zhou, Han Lin, Xiaoju Su, Pingping Zhang, Chunting Fu, Xiangyu Kong, Zhendong Jin, Zhaoshen Li, Yiqi Du, Huiyun Zhu
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Gwang Ha Kim, Kwang An Kwon, Do Hyun Park, Jimin Han
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Shali Tan, Chunyu Zhong, Yutang Ren, Xujuan Luo, Jin Xu, Yan Peng, Xiangsheng Fu, Xiaowei Tang
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Patrick Suggs, Timothy NeCamp, John Alfred Carr
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6,710
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Training in Endoscopy: Endoscopic Ultrasound
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Chang Min Cho
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Clin Endosc 2017;50(4):340-344. Published online July 31, 2017
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DOI: https://doi.org/10.5946/ce.2017.067
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Abstract
PDFPubReaderePub
- Endoscopic ultrasound (EUS) has been recently established as an indispensable modality for the diagnosis and management of pancreatobiliary and gastrointestinal (GI) disorders. EUS proficiency requires both cognitive and technical abilities, including an understanding of the appropriate indications, the performance of appropriate evaluations before and after the procedure, and the management of procedure-related complications. An increasing demand for skills to handle a growing range of interventional EUS procedures and a continual shortage of EUS training programs are two major obstacles for EUS training. Acquiring the skills necessary to comprehend and conduct EUS often requires training beyond the scope of a standard GI fellowship program. In addition to traditional formal EUS training and preceptorships, regular short-term intensive EUS training programs that provide training at various levels may help EUS practitioners improve and maintain EUS-related knowledges and skills. Theoretical knowledge can be acquired from lectures, textbooks, atlases, slides, videotapes, digital video discs, interactive compact discs, and websites. Informal EUS training is generally based on 1- or 2-day intensive seminars, including didactic lectures, skills demonstrated by expert practitioners through live video-streaming of procedures, and hands-on learning using animal or phantom models.
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Citations
Citations to this article as recorded by - Clinical value of the nomogram model based on endoscopic ultrasonography radiomics and clinical indicators in identifying benign and malignant lesions of the pancreas
Xiaofei Fan, Jia Huang, Xiaohan Cai, Ayixie Maihemuti, Shu Li, Weili Fang, Bangmao Wang, Wentian Liu
Frontiers in Oncology.2025;[Epub] CrossRef - How to achieve the long-term goals of EUS training——survey on the performance of diagnostic EUS by newly trained endosonographers and analysis of the influencing factors
Song Zhang, Congqiang Shen, Shanshan Shen, Yonghua Shen, Lei Wang, Ying Lv
BMC Medical Education.2025;[Epub] CrossRef - An optimal curriculum for training in endoscopic ultrasound: a summarized evidence-based literature systematic review
Julieta Montanelli, Ariosto Honorio Hernandez Lara, Ana Karla Uribe Rivera, Juan Manuel Verde, Eike Burmester, Mohammad A. Al-Haddad, Stephan Hollerbach, Peter Vilmann, Monder Abu-Suboh Abadia, Abdenor Badaoui, Paolo Giorgio Arcidiacono, Christoph Schlag,
Surgical Endoscopy.2025;[Epub] CrossRef - UK and Ireland Joint Advisory Group (JAG) consensus statements for training and certification in diagnostic endoscopic ultrasound (EUS)
Tareq El Menabawey, Raymond McCrudden, Dushyant Shetty, Andrew D Hopper, Matthew T Huggett, Noor Bekkali, Nicholas R Carroll, Elaine Henry, Gavin J Johnson, Margaret G Keane, Mark Love, Colin J McKay, Sally Norton, Kofi Oppong, Ian Penman, Jayapal Ramesh,
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Abdenor Badaoui, Sara Teles de Campos, Pietro Fusaroli, Rodica Gincul, Michel Kahaleh, Jan-Werner Poley, Leonardo Sosa Valencia, Laszlo Czako, Angels Gines, Tomas Hucl, Evangelos Kalaitzakis, Maria Chiara Petrone, Riadh Sadik, Lydi van Driel, Lieven Vande
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Gastrointestinal Endoscopy.2024; 99(2): 271. CrossRef - Construction and validation of an endoscopic ultrasonography-based ultrasomics nomogram for differentiating pancreatic neuroendocrine tumors from pancreatic cancer
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Frontiers in Oncology.2024;[Epub] CrossRef - Analysis of the variation in learning curves for achieving competency in convex EUS training: a prospective cohort study using a standardized assessment tool
Masafumi Chiba, Masayuki Kato, Yuji Kinoshita, Takafumi Akasu, Hiroaki Matsui, Nana Shimamoto, Youichi Tomita, Takahiro Abe, Keisuke Kanazawa, Shintaro Tsukinaga, Masanori Nakano, Yuichi Torisu, Hirobumi Toyoizumi, Machi Suka, Kazuki Sumiyama
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JohnGásdal Karstensen, LeizlJoy Nayahangan, Lars Konge, Peter Vilmann
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Claudio G. DE ANGELIS, Stefano RIZZA, Felice RIZZI, Wilma DEBERNARDI VENON, Stefania CARONNA, Silvia GAIA, Mauro BRUNO
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KSGE
