Skip to main content

Advertisement

SpringerLink
Log in

L’écho-endoscopie du pancréas: un mariage de convenance

Endoscopic ultrasonography of the pancreas: a marriage of convenience

  • Published:
Acta Endoscopica

Résumé

L’utilisation d’un écho-endoscope permet de contourner les deux principaux obstacles qui s’opposent à ce que l’échographie percutanée fournisse une analyse satisfaisante du pancréas et des voies biliaires: la distance qui sépare le transducteur de la structure cible d’une part, la gêne occasionnée par le panicule adipeux sous-cutané et les artéfacts gazeux du tube digestif d’autre part.

Mon expérience qui porte maintenant sur plus de 15 000 examens bilio-pancréatiques et l’analyse de la littérature récente, me permettent d’affirmer que l’écho-endoscopie va occuper dans les années à venir une place centrale dans l’imagerie bilio-pancréatique non invasive. J’envisagerai successivement les principes et aspects techniques de la méthode puis ses limites, et enfin ses principales indications dans les maladies du pancréas.

Summary

Using endoscopic ultrasonography, it is possible to get round the two main obstacles to satisfactory analysis of the pancreas and the bile ducts by means of transcutaneous ultrasonography. These are the distance between the transducer and the structure to be operated, and the obstruction caused by the subcutaneouspanniculus adiposus and the gaseous artifacts of the gastro-intestinal tract.

My own experience of now over 15,000 pancreatico-biliary examinations coupled with an analysis of recent literature have led me to conclude that endoscopic ultrasonography will have a central part to play in non-invasive pancreatico-biliary imaging in the years ahead. I shall consider in turn the principles and technical aspects of this method, its limits and then its main applications regarding pancreatic diseases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Références

  1. PALAZZO L. — L’écho-endoscopie pancréatique. In L’échoendoscopie digestive, Palazzo L, Roseau G, Eds. Masson 1992, Paris.

  2. IKEDA M., FUJIMO M.A., MOROZUMI A.et al. — Diagnosis of small pancreatic tumor by endoscopic ultrasonography.Gastroenterology, 1989,96, 225 (abstract).

    Google Scholar 

  3. SUGIYAMA S., ASADA M., FUJITA R., SUGATA F. — Endoscopic ultrasonography for the diagnosis of pancreatic carcinoma.Endoscopy, 1988,20, 94 (abstract).

    Google Scholar 

  4. FUKUDA M., NAKANO Y., SAITO K.et al. — Endoscopic ultrasonography in the diagnosis of pancreatic carcinoma.Scan. J. Gastroenterol., 1984,19 (suppl. 94), 65–76.

    Google Scholar 

  5. KAUFMAN A.R., SIVAK M.V. — Endoscopic ultrasonography in the differential diagnosis of pancreatic disease.Gastrointest. Endosc., 1989,35, 214–219.

    PubMed  CAS  Google Scholar 

  6. KERIVEN-SOUQUET O., SOUQUET J.C., PONCHON T.et al. — Endoscopic ultrasonography for the diagnosis of pancreatic cancer: prospective study in 52 patients with non-informative abdominal ultrasound.Gastrointest. Endosc., 1995,41, 425 (abstract).

    Article  Google Scholar 

  7. MÜLLER M.F., MEYENBERGER C., BERTSCHINGER P.et al. — Pancreatic tumors: evaluation with endoscopic US, CT and MR imaging.Radiology, 1994,190, 745–751.

    PubMed  Google Scholar 

  8. FORSMARK C.E., ALBERT C.A., LAMBIASE L.et al. — Diagnostic tests for pancreatic cancer.Gastrointest. Endosc., 1993,39, A314 (abstract).

    Google Scholar 

  9. HAYASHI Y., NAKAZAWA S., KIMOTO E.et al. — Clinicopathological analysis of endoscopic ultrasonograms in pancreatic mass lesions.Endoscopy, 1989,21, 121–125.

    PubMed  CAS  Google Scholar 

  10. GIOVANNINI M., SEITZ J.F. — Endoscopic ultrasonography with a linear type echoendoscope in the evaluation of 94 patients with pancreato-biliary disease.Endoscopy, 1994,26, 579–585.

    PubMed  CAS  Google Scholar 

  11. KALLIMANIS G., AXIOTIS E., PAPANTONIOU P.et al. — EUS, ERCP, US, CT in the diagnosis of pancreatic cancer.Endoscopy, 1992,24, 656 (abstract).

    Google Scholar 

  12. TIO T.L., SIE L.H., TYTGAT G.N.J. — Endosonography and cytology in diagnosing and staging pancreatic body and tail carcinoma.Dig. Dis. Sci., 1993,38, 59–64.

    Article  PubMed  CAS  Google Scholar 

  13. AKAHOSHI C., CHIJIIWA Y., NAKANO I.et al. — Role of endosonography in diagnosis and staging of pancreatic cancer.Endoscopy, 1995 (in press).

  14. PALAZZO L., ROSEAU G., GAYET B.et al. — Endoscopic ultrasonography in the diagnosis and staging of pancreatic adenocarcinoma. Results of a prospective study with comparison to ultrasonography and CT Scan.Endoscopy, 1993,25, 143–150.

    PubMed  CAS  Google Scholar 

  15. NAKAIZUMI A., UEHARA H., LISHI H.et al. — Endoscopic utrasonography in diagnosis and staging of pancreatic cancer.Dig. Dis. Sci., 1995,40, 696–700.

    Article  PubMed  CAS  Google Scholar 

  16. YASUDA K., MUKAI H., FUJIMOTO S.et al. — The diagnosis of pancreatic cancer by endoscopic ultrasonography.Gastrointest. Endosc., 1988,34, 1–8.

    PubMed  CAS  Google Scholar 

  17. RÖSCH T., LORENZ R., BRAIG C.et al. — Endoscopic ultrasound in pancreatic tumor diagnosis.Gastrointest. Endosc., 1991,37, 347–352.

    PubMed  Google Scholar 

  18. RÖSCH T., NEUHAUS H., GMEINWIESER J.et al. — Role of endoscopic ultrasonography in the evaluation of patients with suspected pancreatic disease.Gastroenterology, 1993,104, A21 (abstract).

  19. WIERSEMA M.J., CHAK A., HAWES R.H., KOPECKY K.K. — Evaluation of endosonography in distinguishing malignant from inflammatory pancreatic masses.Gastrointest. Endosc., 1993,39, A336 (abstract).

  20. RÖSCH T., RODER J.R., DECASSIAN T.et al. — Indeterminate pancreatic tumors: still a problem even with modern diagnostic methods.Endoscopy, 1995,27 (abstract) (in press).

  21. GIOVANNINI M., SEITZ J.F., MONGEST G.et al. — Fineneedle aspiration biopsy guided by endoscopic ultrasonography. Results in 141 patients.Endoscopy, 1995,27, 171–177.

    PubMed  CAS  Google Scholar 

  22. WIERSEMA M.J., KOCHMAN M.L., CRAMER H.M.et al. — Endosonography-guided real-time fine-needle aspiration biopsy.Gastrointest. Endosc., 1994,40, 700–707.

    PubMed  CAS  Google Scholar 

  23. BHUTANI M., HOFFMAN B., VAN VELSE A.et al. — Endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) of malignant pancreatic lesions: accuracy, safety and clinical utility.Gastrointest. Endosc., 1995,41, 298 (abstract).

    Google Scholar 

  24. CHANG K., NGUYEN P., DURBIN T.et al. — Endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) in the diagnosis and staging of pancreatic carcinoma.Gastrointest. Endosc., 1994,40, P62 (abstract).

  25. YASUDA K., MUKAI H., NAKAJIMA M., KAWAI K. — Staging of pancreatic carcinoma by endoscopic ultrasonography.Endoscopy, 1993,25, 151–155.

    PubMed  CAS  Google Scholar 

  26. RÖSCH T., DITTLER H.J., STROBEL K.et al. — Local staging of pancreatic head cancer by endoscopic ultrasonography: a re-evaluation using blind videotape assessment.Endoscopy, 1995,27, (abstract) (in press).

  27. RÖSCH T., BRAIG C., GAIN T.et al. — Staging of pancreatic and ampullary carcinoma by endoscopic ultrasonography.Gastroenterology, 1992,102, 188–199.

    PubMed  Google Scholar 

  28. AMOUYAL P., PALAZZO L., AMOUYAL G.et al. — Endosonography: promising method for diagnosis of extrahepatic cholestasis.Lancet, 1989,11, 1195–1198.

    Article  Google Scholar 

  29. SNADY H., COOPERMAN A., SIEGEL J.H. — Assessment of vascular involvement by pancreatic disease: a comparison of endoscopic ultrasonography to computerized tomography and angiography.Gastrointest. Endosc., 1990,36, 197 (abstract).

    Google Scholar 

  30. RÖSCH T., LORENZ R., NEUHAUS H.et al. — The value of endoscopic ultrasound in chronic pancreatitis.Gastroenterology, 1991,5 (2), A791.

    Google Scholar 

  31. AMOUYAL G., BELLAICHE G., AMOUYAL P.et al. — Intérêt de l’écho-endoscopie dans le diagnostic de pancréatite chronique alcoolique. Résultats définitifs d’une étude prospective sur 52 patients.Gastroenterol. Clin. Biol., 1993,17, A84.

    Google Scholar 

  32. WIERSEMA M.J., HAWES R.H., LEHMAN G.A.et al. — Prospective evaluation of endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography in patients with chronic abdominal pain of suspected pancreatic origin.Endoscopy, 1993,25, 555–564.

    PubMed  CAS  Google Scholar 

  33. BUSCAIL L., DELVAUX M., MOREAU J.et al. — Comparison of endoscopic ultrasonography and ERCP as diagnostic tools in patients with suspected chronic pancreatitis.Gastrointest. Endosc., 1993,39, A312.

    Google Scholar 

  34. WIERSEMA M.J., SCHWARTZ S.M., HAWES R.H.et al. — Abnormalities of pancreas parenchymal and ductular features detected by endosonography in asymptomatic subjects with a history of moderate to heavy alcohol use.Gastrointest. Endosc., 1993,39, A336.

  35. NATTERMANN C., GOLDSCHMIDT A.J.W., DANCYGIER H.et al. — Endosonography in chronic pancreatitis: a comparison between endoscopic retrograde pancreatography and endoscopic ultrasonography.Endoscopy, 1993,25, 565–570.

    Article  PubMed  CAS  Google Scholar 

  36. DAHAN P., AMOUYAL P., AMOUYAL G.et al. — Is EUS helpful in patients with suspicion of complicated gallstone and normal ultrasonography.Gastroenterology, 1993,104, A358 (abstract).

  37. PALAZZO L., ROSEAU G., CHAUSSADE S.et al. — Dystrophie kystique sur pancréas aberrant de la paroi duodénale associée à la pancréatite chronique calcifiante alcoolique: une affection fréquente et méconnue.Gastroenterol. Clin. Biol., 1992,16, A141.

  38. NAPOLEON B., PUJOL B., PONCHON T.et al. — Tumeurs kystiques du pancréas: l’écho-endoscopie permet-elle de choisir entre chirurgie et surveillance?Gastroenterol. Clin. Biol., 1993,17, A89.

    Google Scholar 

  39. AMOUYAL P., GENUIST F., AMOUYAL G.et al. — Intérêt de l’écho-endoscopie dans le diagnostic des cystadénomes et cystadénocarcinomes du pancréas. Etude prospective de 15 cas.Gastroenterol. Clin. Biol., 1992,16, A142.

    Google Scholar 

  40. PALAZZO L., LANDI B., ROSEAU G.et al. — Is endoscopic ultrasonography useful for the diagnosis and management of intraductal mucin hypersecreting neoplams of the pancreas.Gastrointest. Endosc., 1994,40, A217.

    Google Scholar 

  41. LEVY M., LEVY P., HAMMEL P.et al. — Diagnostic des cystadénomes et cystadénocarcinomes du pancréas. Etude de 35 cas.Gastroenterol. Clin. Biol., 1995,19, 189–196.

    PubMed  CAS  Google Scholar 

  42. GLOVER J.R., SHARVON P.J., LEES W.R. — Endoscopic ultrasound for localisation of islet cell tumors.Gut, 1992,33, 108–110.

    Article  PubMed  CAS  Google Scholar 

  43. PALAZZO L., ROSEAU G., SALMERON M.et al. — Endoscopic ultrasonography in the preoperative localisation of pancreatic endocrine tumors.Endoscopy, 1992,24, 350–353.

    PubMed  Google Scholar 

  44. RUSNIEWSKI P., AMOUYAL P., AMOUYAL G.et al. — Endoscopic ultrasonography (EUS) in the localisation of insulinomas: results of a multicenter prospective study.Gastroenterology, 1993,104, A346.

    Google Scholar 

  45. ZIMMER T.H., ZIEGLER K., HAMM B.et al. — Endoscopic ultrasonography and somatostatin-receptor imaging in the localisation and staging of neuroendocrine tumors of the upper GI tract: two relevant diagnostic procedures.Gastroenterology, 1993,104, A346.

    Google Scholar 

  46. RÖSCH T., LIGHTDALE C.J., BOTET J.F.et al. — Endosonographic localisation of pancreatic endocrine tumors.N. Engl. J. Med., 1992,326, 1721–1726.

    PubMed  Google Scholar 

  47. RUSNIEWSKI P., AMOUYAL P., AMOUYAL G.et al. — Diagnostic value of endoscopic ultrasonography for the localisation of gastrinomas.Gastroenterology, 1993,104, A331.

    Google Scholar 

  48. PALAZZO L., BORROTTO E., NAPOLEON B.et al. — Valeur de l’écho-endoscopie dans le diagnostic de localisation des tumeurs endocrines pancréatiques et duodénales chez les malades atteints de néoplasie endocrine multiples.Gastroenterol. Clin. Biol., 1994,18, A78.

    Google Scholar 

Download references

Author information

Author notes

  1. L. Palazzo

    Present address: Clinique de Turin, 75008, Paris, France

Authors and Affiliations

  1. Département des maladies de l’appareil digestif, Hôpital Laënnec, 75007, Paris, France

    L. Palazzo

Authors
  1. L. Palazzo
    View author publications

    You can also search for this author in PubMed Google Scholar

About this article

Cite this article

Palazzo, L. L’écho-endoscopie du pancréas: un mariage de convenance. Acta Endosc 26, 137–144 (1996). https://doi.org/10.1007/BF02965801

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02965801

Mots-clés

Key-words

Search

Navigation