Clinic

Mural and extramural lesions

·         Diagnosis of cyst, GIST, submucosal mass (assessment before mucosectomy, ESD)

·         Thickened gastric fold

·         Determine cause of GI tract stricture (anastomotic, reflux, extrinsic compression, achalasia)

Staging of GI tract malignancies

·         Oesophageal and gastric cancer

·         Gastric lymphoma / MALToma

·         Detection of malignant ascites and peritoneal metastases

·         Restaging after chemotherapy

Staging of non-GI tract malignancies

·         Non-small cell lung cancer

·         Mediastinal tumour / lymph node

·         (Gynaecological cancer)

Biliary diseases

·         Common bile duct stones, sludge and cancer

·         GB tumour, stone, polyps and other pathologies

New methods

EUS harmonic contrast study

EUS elastography

Pancreatic diseases

·         Pancreatic and ampullary cancer

·         Endocrine tumour, cystic tumour , IPMT

·         Acute, chronic and idiopathic pancreatitis

·         Assessment of pseudocyst (before drainage)

Colorectal diseases

·         Colorectal cancer and large polyps

·         Colorectal submucosal mass and carcinoid

·         IBD (CD, UC)

·         Fistula-in-ano, incontinence, pelvic floor dysfunction

·         Early detection of rectal tumour recurrence

·         Pelvic diseases (abscess, prostate, endometriosis, etc)

Portal hypertension

·         Diagnosis of gastroesophageal varices and collaterals

·         Monitoring drug and endoscopic therapy

·         Haemodynamic study

Dyspepsia and unexplained abdominal pain

EUS-FNA of tumours

·         GIT stromal tumour (GIST, leiomyoma, linitus plastica, etc)

·         Lung tumour and metastases

·         Liver metastases

·         Adrenal metastases

Pancreatic lesion

·         Solid pancreatic mass

·         Cystic lesion - FNA for fluid analysis, EUS guided brush cytology, EUS guided direct intra-cystic biopsy

·         EUS tattoo of small neuroendocrine tumour

EUS-FNA of lymph node in GIT cancer

·         Peri-esophageal, celiac axis lymph node

·         Peri-gastric

·         Peri-pancreatic

·         Peri-rectal

EUS (EBUS) - FNA of mediastinal lymph node for staging of NSCLC

EUS (EBUS) - FNA of other mediastinal lymph nodes and masses

·         Metastases

·         Lymphoma

·         TB, Sarcoidosis, Histoplasmosis, etc

EUS-FNA of other lesions

·         Ascites

·         Pleural effusion

·         Pericardial effusion

EUS-guided injection therapy

‧          Celiac plexus neurolysis

‧          Broad plexus neurolysis (around SMA)

‧          (Hypogastric plexus neurolysis)

‧          Botox injection for achalasia

‧          Sclerotherapy of OV and GV

‧          Lavage (alcohol, paclitaxel) of pancreatic cystic tumour

EUS-guided tumour therapy

‧          Iodine 125 seeds placement for brachytherapies

‧          Fiducial placement for stereotactic radiation

‧          (Tumour ablation – thermal probe, cryo probe, photodynamic probe, laser probe,  radiofrequency (High intensity focused ultrasound, HIFU) )

‧           

(EUS-guided tumour injection therapy)

‧          Injection of cytoimplant, gene therapy, chemotherapeutic agents, immune modulators

‧          Alcohol ablation of liver metastases, small pancreatic neuroendocrine tumour, etc.

EUS-guided abscess drainage

·         Liver abscess

·         Sub-phrenic abscess

·         Peri-rectal abscess

EUS-guided ERCP

·         Pancreatic ductal cannulation

·         CBD rendezvous cannulation

EUS-guided drainage

‧          Pancreatic pseudocyst drainage

‧          Pancreatico-gastrostomy (EPG)

‧          Choledocho-duodenostomy

‧          Cholecysto-duodenostomy

‧          Hepatico-gastrostomy

EUS guide vascular therapy

·         Cyanoacrylate injection for bleeding varices and aneurysm

·         Endocoil placement for varices and aneurysm

·         (TIPS placement)

(EUS guided anastomotic surgery)

‧          Gastro-jejunostomy

‧          Choledocho-duodenostomy

EUS-guided angiography

EUS guided needle confocal endomicroscopy