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Ryota Nakano,Hideyuki Shiomi,Shogo Ota,Hiroko Iijima 소화기인터벤션의학회 2022 Gastrointestinal Intervention Vol.11 No.3
Cancer associated abdominal pain, as typified by pancreatic cancer, has conventionally been treated with narcotic drugs, but often the severe abdominal pain is difficult to control. Endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) is commonly performed for abdominal pain that is difficult to control. EUS-CPN can be performed more safely and reliably than other conventional procedures on the celiac plexus, and good outcomes of pain relief have been reported. Although a variety of endoscopic techniques are available for EUS-CPN, the choice varies among institutions, and evidence on the efficacy and safety of each procedure is limited. In this review, we summarize the indications for treatment, specific endoscopic techniques, therapeutic efficacy for pain relief, and complications from previous reports on EUS-CPN.
Ryota Nakano,Hideyuki Shiomi,Shogo Ota,Hiroko Iijima 소화기인터벤션의학회 2022 International journal of gastrointestinal interven Vol.11 No.3
Cancer associated abdominal pain, as typified by pancreatic cancer, has conventionally been treated with narcotic drugs, but often the severe abdominal pain is difficult to control. Endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) is commonly performed for abdominal pain that is difficult to control. EUS-CPN can be performed more safely and reliably than other conventional procedures on the celiac plexus, and good outcomes of pain relief have been reported. Although a variety of endoscopic techniques are available for EUS-CPN, the choice varies among institutions, and evidence on the efficacy and safety of each procedure is limited. In this review, we summarize the indications for treatment, specific endoscopic techniques, therapeutic efficacy for pain relief, and complications from previous reports on EUS-CPN.
Endoscopic Ultrasound-Guided Gastroenterostomy for Afferent Loop Syndrome
Hideyuki Shiomi,Arata Sakai,Ryota Nakano,Shogo Ota,Takashi Kobayashi,Atsuhiro Masuda,Hiroko Iijima 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.6
Afferent loop syndrome (ALS) is a mechanical obstruction of the afferent limbs after gastrectomy with gastrojejunostomyreconstruction. Patients with cancer recurrence require immediate and less invasive treatment because of their poor condition. Percutaneous transhepatic/transluminal drainage (PTD) and endoscopic enteral stenting offer reasonable palliative treatment formalignant ALS but are not fully satisfactory in terms of patient quality of life (QoL) and stent patency. Endoscopic ultrasound-guidedgastroenterostomy (EUS-GE) using a lumen-apposing metal stent may address these shortcomings. Clinical data from 11 reportsshowed that all patients who had undergone EUS-GE had positive technical and clinical outcomes. The adverse event rate was11.4%, including only mild or moderate abdominal pain, with no severe adverse events. Indirect comparative studies indicated thatpatients who had undergone EUS-GE had a significantly superior QoL, a higher clinical success rate, and a lower reintervention ratethan those who had undergone PTD or endoscopic enteral stenting. Although the evidence is limited, EUS-GE may be consideredas a first-line treatment for malignant ALS because it has better clinical outcomes than other less invasive treatments, such as PTD orendoscopic enteral stenting. Further prospective randomized control trials are necessary to establish EUS-GE as a standard treatmentfor ALS.
이재영,Minami Yasunori,최병인,이원재,Chou Yi-Hong,정우경,박미숙,Kudo Nobuki,이민우,Kamata Ken,Iijima Hiroko,김소연,Numata Kazushi,Sugimoto Katsutoshi,Maruyama Hitoshi,Sumino Yasukiyo,Ogawa Chikara,Kitano Masayuki,주이진,Arit 대한초음파의학회 2020 ULTRASONOGRAPHY Vol.39 No.3
The first edition of the guidelines for the use of ultrasound contrast agents was published in 2004, dealing with liver applications. The second edition of the guidelines in 2008 reflected changes in the available contrast agents and updated the guidelines for the liver, as well as implementing some nonliver applications. The third edition of the contrast-enhanced ultrasound (CEUS) guidelines was the joint World Federation for Ultrasound in Medicine and Biology�European Federation of Societies for Ultrasound in Medicine and Biology (WFUMB-EFSUMB) venture in conjunction with other regional US societies such as Asian Federation of Societies for Ultrasound in Medicine and Biology, resulting in a simultaneous duplicate on liver CEUS in the official journals of both WFUMB and EFSUMB in 2013. However, no guidelines were described mainly for Sonazoid due to limited clinical experience only in Japan and Korea. The new proposed consensus statements and recommendations provide general advice on the use of Sonazoid and are intended to create standard protocols for the use and administration of Sonazoid in hepatic and pancreatobiliary applications in Asian patients and to improve patient management.