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Echoendoscopie interventionnelle: drainage de pseudokystes, pancréatogastrostomie alcoolisation cœliaque et des kystes pancréatiques

Interventional endosonography: pseudocyst drainage, celiac block, pancreatogastrostomy ethanol lavage of pancreatic cystic lesions

  • Published:
Acta Endoscopica

Résumé

Les indications thérapeutiques de l’échoendoscopie (EED) peuvent être réparties en deux groupes majeurs: le drainage des collections ou des canaux biliaires et pancréatiques et l’injection de substances à visée ablative ou d’anesthésie avec une aiguille fine. Les deux techniques réellement passées en pratique clinique sont le drainage des collections stériles ou infectées pancréatiques et le bloc cœliaque ou la neurolyse cœliaque. Plus récemment, ont été introduites les ablations par injection d’alcool de tumeurs kystiques et de tumeurs endocrines pancréatiques. L’injection d’agents cytotoxiques, la thérapie génique et l’implantation de matériel radioactif dans diverses tumeurs dont les cancers du pancréas par échoendoscopie paraissent prometteuses mais doivent encore être considérées comme expérimentales. Cet article va revoir le rôle thérapeutique de l’échoendoscopie dans le drainage des collections liquidiennes pancréatiques, l’ablation de tumeurs kystiques et endocrines pancréatiques et la phénolisation cœliaque.

Summary

Interventional endosonography indications can be divided into two groups of applications: fluid collections or pancreaticobiliary duct drainage and fine needle injection of substances in tumours or neural regions. The two most clinically relevant applications are the drainage of pancreatic sterile or infected fluid collections and celiac plexus block or neurolysis. More recently, the feasibility and safety of ethanol lavage of pancreatic cystic tumours and ethanol ablation of endocrine lesions have been demonstrated. Experimental promising EUS applications include delivery of cytotoxic agents such as chemotherapy, gene therapy, and radioactive seeds. This article will review the therapeutic role of EUS in drainage of pancreatic fluid collections, ethanol ablation of pancreatic tumours, lavage of pancreatic cysts, and alcoholisation of the celiac plexus.

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Author notes

  1. P. H. Deprez

    Present address: Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Av Hippocrate 10, 1200, Bruxelles, Belgique

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    Deprez, P.H. Echoendoscopie interventionnelle: drainage de pseudokystes, pancréatogastrostomie alcoolisation cœliaque et des kystes pancréatiques. Acta Endosc 38, 43–50 (2008). https://doi.org/10.1007/BF02961973

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    • DOI: https://doi.org/10.1007/BF02961973

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