Journal of Clinical Medicine

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Special Issue Information

Dear Colleagues,

In recent years, we have seen significant progress in the application of endoscopic techniques for pancreaticobiliary diseases, the development of endoscopy ultrasound (EUS) being of particular note, which has become an important tool for the diagnosis and treatment of pancreatic diseases. As an endoscopic imaging modality, EUS combines both endoscopy and ultrasound techniques to detect the disease more accurately than other diagnostic tools. New artificial intelligence models are currently being applied to EUS to further improve its diagnostic capabilities. In addition, many EUS-guided procedures such as EUS-guided drainage and EUS-guided radiofrequency ablation have also demonstrated the great potential of EUS in the treatment of pancreatic diseases. The development of interventional EUS has revolutionized the endoscopic treatment of pancreaticobiliary diseases.

This Special Issue aims to discuss and provide advances and perspectives on endoscopic ultrasound in the diagnosis and treatment of pancreatic diseases. We encourage you to submit your original articles and review articles related to this topic considering future developments and innovations.

Dr. Stefano Francesco Crinò
Guest Editor

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Keywords

endoscopic ultrasound (EUS)
pancreatic diseases
interventional EUS
endoscopic retrograde cholangiopancreatography (ERCP)
EUS-guided procedures
diagnosis and treatment

Published Papers (2 papers)

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Research

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12 pages, 1242 KiB

Open AccessFeature PaperArticle

Safety and Diagnostic Yield of Endoscopic Ultrasound-Guided Fine-Needle Biopsy for Hypervascular Pancreatic Lesions

by Wataru Hamamoto, Takumi Onoyama, Shiho Kawahara, Yuri Sakamoto, Hiroki Koda, Taro Yamashita, Yohei Takeda, Kazuya Matsumoto, Kenichi Harada, Naoyuki Yamaguchi and Hajime Isomoto

J. Clin. Med. 2023, 12(20), 6663; https://doi.org/10.3390/jcm12206663 - 21 Oct 2023

Viewed by 949

Abstract

Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) is a common technique for diagnosing pancreatic lesions with high accuracy and a low incidence of procedural adverse events. However, occasional adverse events, particularly bleeding, may occur. Procedures for hypervascular lesions are considered important, but their risks are unknown. We aimed to evaluate the safety and diagnostic yield of EUS-FNB for hypervascular pancreatic solid lesions. This study included 301 patients with 308 solid pancreatic lesions who underwent EUS-FNB between May 2011 and December 2018. We performed propensity-score matching to balance clinical differences between hypervascular and hypovascular lesions and analyzed 52 lesions. We compared the safety and diagnostic performance of propensity score-matched cohorts. The sensitivity, specificity, and accuracy rates of EUS-FNB for hypervascular lesions were 94.7%, 100%, and 96.2%, and those for hypovascular lesions were 80.0%, 100%, and 84.6%, respectively. There was no difference in diagnostic performance between hypervascular and hypovascular lesions. Furthermore, adverse events occurred in only one patient (pancreatitis) in the hypovascular group. There were no significant differences in the occurrence of adverse events between hypervascular and hypovascular lesions (0% vs. 3.8%, p = 1.000). Therefore, EUS-FNB may be safe with a high diagnostic yield, even for hypervascular solid pancreatic lesions. Full article

(This article belongs to the Special Issue Advances in Endoscopic Ultrasound for Pancreatic Diseases)

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Review

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12 pages, 1412 KiB

Open AccessReview

Real-Life Management of Pancreatic Cysts: Simplified Review of Current Guidelines

by Cătălina Vlăduţ, Dana Bilous and Mihai Ciocîrlan

J. Clin. Med. 2023, 12(12), 4020; https://doi.org/10.3390/jcm12124020 - 13 Jun 2023

Cited by 1 | Viewed by 3799

Abstract

Pancreatic cysts are becoming a popular diagnostic tool due to the increased availability of high-quality cross-sectional imaging. Pancreatic cystic lesions constitute closed, liquid-containing cavities, which are either neoplastic or non-neoplastic. While serous lesions often follow a benign course, mucinous lesions can hide carcinoma and, therefore, require different management. Moreover, all cysts should be considered mucinous until proven otherwise, thus limiting the errors in managing these entities. Due to the need for high contrast soft tissue imaging, magnetic resonance imaging represents an elective, non-invasive diagnostic tool. Endoscopic ultrasound (EUS) has started gaining more prominence with regard to the proper diagnosis and management of pancreatic cysts, offering quality information with minimal risks. Enabling both the acquisition of endoscopic images of the papilla and the endosonographic high-quality evaluation of septae, mural nodules along with the vascular patterns of the lesion contribute to a definitive diagnosis. Moreover, the possibility of obtaining cytological or histological samples could become mandatory in the foreseeable future, allowing for more precise molecular testing. Future research should focus on detecting methods to quickly diagnose high-grade dysplasia or early cancer for patients with pancreatic cysts, thus allowing time for appropriate treatment and avoiding surgical overtreatment or over surveillance in selected cases. Full article

(This article belongs to the Special Issue Advances in Endoscopic Ultrasound for Pancreatic Diseases)

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