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Endosonographie interventionnelle

Interventional endosonography

  • Published:
Acta Endoscopica

Résumé

L’ultrasonographie endoscopique a principalement été utilisée comme instrument diagnostique, mais maintenant elle est de plus en plus utilisée dans des techniques diagnostiques plus invasives, ainsi que pour faciliter des procédures endoscopiques thérapeutiques. L’aspiration transintestinale à l’aiguille fine (AAF) réalisée sous le contrôle direct USE, permet la réalisation de biopsies de masses et de ganglions lymphatiques adjacents à la paroi intestinale. La même technique AAF a aussi permis de réaliser des cholangio-pancréatographies, des thoracocentèses transoesophagiennes, des paracentèses transgastriques, des drainages de pseudo-kystes transintestinaux, et des blocages du plexus nerveux cœliaque. L’USE a été utilisée comme aide pour la détermination de la résécabilité endoscopique de masses sous-muqueuses, du placement difficile de gastrostomies endoscopiques percutanées, et pour l’amélioration de l’hémostase endoscopique.

Quoique ces techniques soient encore nouvelles et nécessitent une évaluation complémentaire, elles suggèrent que dans le futur il y aura une place croissante pour l’USE interventionnelle.

Summary

Endoscopic ultrasound (EUS) has mostly been used as a diagnostic tool, but now increasingly it is used in more invasive diagnostic techniques, as well as to assist therapeutic endoscopic procedures. Transintestinal fine needle aspiration (FNA) performed under direct EUS guidance allows for biopsy of masses and lymph nodes located adjacent to the intestinal wall. The same FNA technique has also allowed EUS-guided cholangiopancreatography, transesophageal thoracentesis, transgastric paracentesis, transintestinal pseudocyst drainage, and transgastric celiac plexus nerve blocks. EUS has been used to help determine endoscopic resectability of submucosal masses, place difficult percutaneous endoscopic gastrostomy (PEG) tubes, and optimize endoscopic hemostasis. Although these techniques are still new and need further evaluation, they suggest that in the future there will be increasing use of interventional EUS.

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Author notes

  1. T. J. Savides M.D.

    Present address: Division of Gastroenterology (8413), UCSD Medical Center, 200 West Arbor Drive, 92103-8413, San Diego, California, USA

Authors and Affiliations

  1. Division of Gastroenterology (8413), UCSD Medical Center, 200 West Arbor Drive, 92103-8413, San Diego, California, USA

    F. Gress, S. Ikenberry & R. H. Hawes

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  1. T. J. Savides M.D.
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  2. F. Gress
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  3. S. Ikenberry
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  4. R. H. Hawes
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Savides, T.J., Gress, F., Ikenberry, S. et al. Endosonographie interventionnelle. Acta Endosc 25, 475–481 (1995). https://doi.org/10.1007/BF02966482

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  • DOI: https://doi.org/10.1007/BF02966482

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