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New endoscopic ultrasonography techniques for pancreaticobiliary diseases
Ken Kamata,Masayuki Kitano,Shunsuke Omoto,Kumpei Kadosaka,Takeshi Miyata,Kosuke Minaga,Kentaro Yamao,Hajime Imai,Masatoshi Kudo 대한초음파의학회 2016 ULTRASONOGRAPHY Vol.35 No.3
Endoscopic ultrasonography (EUS) is widely used to evaluate pancreaticobiliary diseases,especially pancreatic masses. EUS has a good ability to detect pancreatic masses, but it isnot sufficient for the differential diagnosis of various types of lesions. In order to address thelimitations of EUS, new techniques have been developed to improve the characterization ofthe lesions detected by EUS. EUS-guided fine needle aspiration (EUS-FNA) has been used fordiagnosing pancreatic tumors. In order to improve the histological diagnostic yield, a EUS-FNAneedle with a core trap has recently been developed. Contrast-enhanced harmonic EUS is a newimaging modality that uses an ultrasonographic contrast agent to visualize blood flow in finevessels. This technique is useful in the diagnosis of pancreatic solid lesions and in confirmingthe presence of vascularity in mural nodules for cystic lesions. EUS elastography analyzes severaldifferent variables to measure tissue elasticity, color patterns, and strain ratio, using analyticaltechniques such as hue-histogram analysis, and artificial neural networks, which are useful forthe diagnosis of chronic pancreatitis and pancreatic cancer.
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Bispectral index-guided propofol sedation during endoscopic ultrasonography
Ayana Okamoto,Ken Kamata,Takeshi Miyata,Tomoe Yoshikawa,Rei Ishikawa,Tomohiro Yamazaki,Atsushi Nakai,Shunsuke Omoto,Kosuke Minaga,Kentaro Yamao,Mamoru Takenaka,Yasutaka Chiba,Toshiharu Sakurai,Naoshi 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.4
Background/Aims: Bispectral index (BIS) monitors process and display electroencephalographic data are used to assess the depth ofanesthesia. This study retrospectively evaluated the usefulness of BIS monitoring during endoscopic ultrasonography (EUS). Methods: This study included 725 consecutive patients who underwent EUS under sedation with propofol. BIS monitoring was usedin 364 patients and was not used in 361. The following parameters were evaluated: (1) median dose of propofol; (2) respiratory and circulatorydepression; (3) occurrence of body movements; (4) awakening score >8 at the time; and (5) awakening score 2 hours afterleaving the endoscopy room. Results: The BIS group received a significantly lower median dose of propofol than the non-BIS group (159.2 mg vs. 167.5 mg;p=0.015) in all age groups. For patients aged ≥75 years, the reduction in heart rate was significantly lower in the BIS group than in thenon-BIS group (1.2% vs. 9.1%; p=0.023). Moreover, the occurrence of body movements was markedly lower in the BIS group than inthe non-BIS group (8.5% vs. 39.4%; p<0.001). Conclusions: During EUS examination, BIS monitoring is useful for maintaining a constant depth of anesthesia, especially in patients75 years of age or older.
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