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Advances in self-expandable metal stents for endoscopic ultrasound-guided interventions
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Dong Kee Jang, Dong Wook Lee, Seong-Hun Kim, Kwang Bum Cho, Sundeep Lakhtakia
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Clin Endosc 2024;57(5):588-594. Published online July 9, 2024
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DOI: https://doi.org/10.5946/ce.2023.169
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 Abstract
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- Endoscopic ultrasound (EUS)-guided interventions have evolved rapidly in recent years, with dedicated metal stents playing a crucial role in this process. Specifically, the invention of biflanged short metal-covered stents, including lumen-apposing metal stents (LAMS), and modifications in a variety of tubular self-expandable metal stents (SEMS), have led to innovations in EUS-guided interventions. LAMS or non-LAMS stents are commonly used in the EUS-guided drainage of pancreatic fluid collections, especially in cases of walled-off necrosis. Additionally, LAMS is commonly considered for drainage of the EUS-guided gallbladder or dilated common bile duct and EUS-guided gastroenterostomy. Fully or partially covered tubular SEMS with several new designs are being considered for EUS-guided biliary drainage. This review focuses on advances in SEMS for EUS-guided interventions and discusses related research results.
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Endoscopic ultrasound-guided intervention for inaccessible papilla in advanced malignant hilar biliary obstruction
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Partha Pal, Sundeep Lakhtakia
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Clin Endosc 2023;56(2):143-154. Published online February 17, 2023
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DOI: https://doi.org/10.5946/ce.2022.198
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Abstract
PDFPubReaderePub
- Advanced malignant hilar biliary obstruction (MHBO) with inaccessible papilla poses a significant challenge to endoscopists, as drainage of multiple liver segments may be warranted. Transpapillary drainage may not be feasible in patients with surgically altered anatomy, duodenal stenosis, prior duodenal self-expanding metal stent, and after initial transpapillary drainage, but require re-intervention for draining separated liver segments. Endoscopic ultrasound-guided biliary drainage (EUS-BD) and percutaneous trans-hepatic biliary drainage are the feasible options in this scenario. The major advantages of EUS-BD over percutaneous trans-hepatic biliary drainage include a reduction in patient discomfort and internal drainage away from the tumor, thus reducing the possibility of tissue or tumor ingrowth. With innovations, EUS-BD is helpful not only for bilateral communicating MHBO but also for non-communicating systems with bridging hilar stents or isolated right intra-hepatic duct drainage by hepatico-duodenostomy. EUS-guided multi-stent drainage with specially designed cannulas and guidewires has become a reality. A combined approach with endoscopic retrograde cholangiopancreatography for re-intervention, interventional radiology, and intraductal tumor ablative therapies has been reported. Stent migration and bile leakage can be minimized with proper stent selection and technique, and stent blocks can be managed with EUS-guided interventions in a majority of cases. Future comparative studies are required to establish the role of EUS-guided interventions in MHBO as rescue or primary therapy.
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Citations
Citations to this article as recorded by  - Endoscopic Management of Malignant Biliary Obstruction
Woo Hyun Paik, Do Hyun Park
Gastrointestinal Endoscopy Clinics of North America.2024; 34(1): 127. CrossRef - The Lambda stenting technique: a new approach to address EUS-guided biliary drainage–associated adverse events
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Endoscopy.2024; 56(S 01): E724. CrossRef - Cholangiocarcinoma – A Detailed Review on Indian Literature
Sanoop Kumar Sherin Sabu, Vinoth Kumar Ramachandran, U. S. Umashankar, Harriprasad Baskkaran, Swetha Sattanathan, Rajendra Prasad Bollupalle, Yalamanchi Sri Ram Srujan, V. Aravinda Narasimhan, Nair Parvati Ramachandran
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Endoscopy.2024; 56(S 01): E943. CrossRef
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Therapy of Pancreatic Neuroendocrine Tumors: Fine Needle Intervention including Ethanol and Radiofrequency Ablation
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Sundeep Lakhtakia
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Clin Endosc 2017;50(6):546-551. Published online November 30, 2017
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DOI: https://doi.org/10.5946/ce.2017.167
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Abstract
PDFPubReaderePub
- Pancreatic neuroendocrine tumors (PNETs) are increasingly being detected, though usually as incidental findings. Majority of the PNETs are non-functional and surgical resection is the standard of care for most of them. However, in patients with small PNETs localized within the pancreas, who are unfit or unwilling for surgery, alternate methods of treatment are needed. Direct methods of ablation of PNETs, using either ethanol injection or radiofrequency ablation (RFA), are emerging as effective methods. The limited literature available as case reports or case series on endoscopic ultrasound (EUS)-guided local ablation using either ethanol or RFA has demonstrated safety and efficacy along with short- to medium-term sustained relief. Long-term benefits with these local ablative therapies are awaited. Comparative studies are needed to show which of these two competing technologies is superior. Finally, comparative trials of EUS-guided ablation with surgical resection in terms of efficacy and safety will ensure their place in the management algorithm.
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Citations
Citations to this article as recorded by - Safety and efficacy of endoscopic ultrasound‐guided radiofrequency ablation for pancreatic neuroendocrine neoplasms: Systematic review and meta‐analysis
Tawfik Khoury, Wisam Sbeit, Pietro Fusaroli, Davide Campana, Nicole Brighi, Bertrand Napoleon, Andrea Lisotti
Digestive Endoscopy.2024; 36(4): 395. CrossRef - Role of Endoscopic Ultrasound-Guided Radiofrequency Ablation in Pancreatic Lesions: Where Are We Now and What Does the Future Hold?
Radhika Chavan, Nirav Thosani, Shivangi Kothari
Cancers.2024; 16(21): 3662. CrossRef - Efficacy and Safety of Endoscopic Ultrasound-Guided Radiofrequency Ablation for Pancreatic Neuroendocrine Tumors: A Systematic Review and Metanalysis
Elia Armellini, Antonio Facciorusso, Stefano Francesco Crinò
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Giuseppinella Melita, Socrate Pallio, Andrea Tortora, Stefano Francesco Crinò, Antonio Macrì, Gianlorenzo Dionigi
Journal of Clinical Medicine.2021; 10(12): 2638. CrossRef - Sunitinib-Loaded Chondroitin Sulfate Hydrogels as a Novel Drug-Delivery Mechanism for the Treatment of Pancreatic Neuroendocrine Tumors
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