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Clinical Advances in Endoscopic Ultrasound-Guided Diagnosis and Treatment
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Clinical Advances in Endoscopic Ultrasound-Guided Diagnosis and Treatment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: 31 July 2025 | Viewed by 7149

Special Issue Editor

Prof. Dr. Nicola Muscatiello

E-Mail Website
Guest Editor
Gastroenterology Unit, Department of Medical Sciences, Ospedali Riuniti di Foggia, Viale Pinto 1, 71100 Foggia, Italy
Interests: gastrointestinal endoscopy; endoscopic ultrasound; cancers; hepatology; ultrasound

Special Issue Information

Dear Colleagues,

An endoscopic ultrasound (EUS) was developed as a diagnostic modality but is rapidly gaining a role in a variety of therapeutic applications. EUS has been used increasingly for the drainage of pancreatic fluid collections, treatment of cystic lesions of the pancreas, EUS-guided cholangiopancreatography, localized therapy for pancreatic tumors and the treatment of gastric varices.

This Special Issue aims to provide an overview of the clinical applications of diagnostic and therapeutic EUS. Original articles and reviews about the indications, patient preparation, technical aspects and adverse events associated with EUS examination of the hepatobiliary and gastrointestinal tract are welcome.

Special interest will be given to cutting-edge technology, as well as an overview of the current guidelines applied in daily clinical practice.

Prof. Dr. Nicola Muscatiello
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • endoscopic ultrasound (EUS)
  • pancreas
  • cancer
  • lumen apposing metal stent (LAMS)
  • stent

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Published Papers (5 papers)

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Research

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9 pages, 1442 KiB  
Article
Multiple Self-Made Side Holes in a Fully Covered Metal Stent Prevent Intrahepatic Bile Duct Occlusion Following Endoscopic Ultrasound-Guided Hepaticogastrostomy: A Retrospective Study in Japan
by Ren Kuwabara, Kazuo Hara, Shin Haba, Takamichi Kuwahara, Nozomi Okuno, Hiroki Koda, Minako Urata, Takashi Kondo, Yoshitaro Yamamoto, Keigo Oshiro and Tomoki Ogata
J. Clin. Med. 2025, 14(11), 3773; https://doi.org/10.3390/jcm14113773 - 28 May 2025
Abstract
Background/Objectives: Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) using a fully covered self-expandable metal stent (FCSEMS) is an alternative to endoscopic retrograde cholangiopancreatography for biliary drainage; however, FCSEMSs may cause intrahepatic bile duct (IHD) obstruction and cholangitis. In this study, we developed an FCSEMS with [...] Read more.
Background/Objectives: Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) using a fully covered self-expandable metal stent (FCSEMS) is an alternative to endoscopic retrograde cholangiopancreatography for biliary drainage; however, FCSEMSs may cause intrahepatic bile duct (IHD) obstruction and cholangitis. In this study, we developed an FCSEMS with multiple self-made side holes at its tip and evaluated its safety and efficacy. Methods: This retrospective study included 100 patients who underwent EUS-HGS with FCSEMS placement between April 2022 and October 2023. Fifty patients received a conventional FCSEMS, and 50 received an FCSEMS with multiple self-made side holes. Technical and clinical success, residual contrast in the IHD, recurrent biliary obstruction (RBO), and adverse events (AEs) were then evaluated. The clinical success rates were 98% and 90% for the side hole and conventional FCEMS groups, respectively. The amount of residual contrast in the IHD was lower in the side hole group (0% vs. 12%, p = 0.027). RBO incidence was significantly lower in the side hole group (8% vs. 30%, p < 0.001), with migration as the primary cause in the conventional group. Early AEs, including segmental cholangitis, occurred only in the conventional group. During reintervention, all stents were safely removed. Conclusions: The FCSEMSs with multiple side holes reduced IHD occlusion and cholangitis, improving biliary drainage and safety. Further studies are needed to confirm these findings. Full article
(This article belongs to the Special Issue Clinical Advances in Endoscopic Ultrasound-Guided Diagnosis and Treatment)
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11 pages, 1411 KiB  
Article
Endoscopic Retrograde Cholangio-Pancreatography and Endoscopic Ultrasound in the Management of Paediatric Acute Recurrent Pancreatitis and Chronic Pancreatitis
by Deepak Joshi, Taimur Shafi, Usama Al-Farsi, Margaret G. Keane, Tassos Grammatikopoulos, Rania Kronfli, Erica Makin, Mark Davenport, Elizabeth Hayward, Andrew Pool, David Reffitt, John Devlin and Philip Harrison
J. Clin. Med. 2024, 13(18), 5523; https://doi.org/10.3390/jcm13185523 - 18 Sep 2024
Cited by 1 | Viewed by 1347
Abstract
Objectives: To evaluate the role of ERCP (endoscopic retrograde cholangio-pancreatography) and EUS (endoscopic ultrasound) and to describe the efficacy and safety of these procedures in a paediatric cohort with chronic pancreatitis (CP) and acute recurrent pancreatitis (ARP). Methods: All patients (<18 [...] Read more.
Objectives: To evaluate the role of ERCP (endoscopic retrograde cholangio-pancreatography) and EUS (endoscopic ultrasound) and to describe the efficacy and safety of these procedures in a paediatric cohort with chronic pancreatitis (CP) and acute recurrent pancreatitis (ARP). Methods: All patients (<18 years) undergoing an ERCP or EUS for ARP and CP between January 2008 and December 2022 were included. Data collection included indications for the procedure, technical success, adverse events and outcome data. Results: A total of 222 ERCPs were performed in 98 patients with CP and ARP (60% female, median age 10 years). The commonest indications were a main pancreatic duct stricture (PD) with or without a stone within the main PD. Successful cannulation was achieved in 98% of cases. Improved stricture resolution was demonstrated in 63% of patients. The overall adverse event rate for ERCP was low (n = 8/222, 3.6%). An improvement in abdominal pain was demonstrated in (75/98) 76% of patients. Their Body Mass Index also significantly improved post ERCP (15.5 ± 1.41 vs. 12.9 ± 1.16 kg/m2, p = 0.001). A total of 54 EUS procedures were undertaken in 48 individuals. Moreover, 35 individuals underwent a therapeutic EUS procedure, for which the commonest indication was the drainage of a pancreatic fluid collection. The overall complication rate was low (n = 2.4%) in all EUS cases. Conclusions: ERCP and EUS can be safely and effectively used in a paediatric population with indications analogous to an adult cohort. Full article
(This article belongs to the Special Issue Clinical Advances in Endoscopic Ultrasound-Guided Diagnosis and Treatment)
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Review

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18 pages, 2625 KiB  
Review
Endoscopic Management of Ampullary Adenomas: A Comprehensive Review
by Minh Thu T. Nguyen, Ruchir Paladiya, Dushyant Singh Dahiya and Murali Dharan
J. Clin. Med. 2025, 14(10), 3532; https://doi.org/10.3390/jcm14103532 - 18 May 2025
Viewed by 250
Abstract
Ampullary adenomas are rare outgrowths at the ampulla of Vater that may progress into cancer via the adenoma-to-carcinoma sequence, particularly in individuals with hereditary polyposis syndrome. Many are diagnosed incidentally or once the lesion becomes large enough to cause obstruction. Traditionally managed surgically [...] Read more.
Ampullary adenomas are rare outgrowths at the ampulla of Vater that may progress into cancer via the adenoma-to-carcinoma sequence, particularly in individuals with hereditary polyposis syndrome. Many are diagnosed incidentally or once the lesion becomes large enough to cause obstruction. Traditionally managed surgically with high morbidity and mortality, advances in imaging and therapy have made endoscopic ampullectomy the first-line treatment for noninvasive lesions. Despite its high success rate and favorable safety profile, complications such as pancreatitis, ductal stenosis, bleeding, recurrence, and perforation can occur. Recommendations for optimal endoscopic techniques and surveillance intervals are largely based on expert opinion in interventional endoscopy and findings from small-scale studies. This review provides an updated framework for the diagnosis and management of ampullary adenomas. Full article
(This article belongs to the Special Issue Clinical Advances in Endoscopic Ultrasound-Guided Diagnosis and Treatment)
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11 pages, 508 KiB  
Review
Impact of GLP-1 Receptor Agonists in Gastrointestinal Endoscopy: An Updated Review
by Sahib Singh, Saurabh Chandan, Dushyant Singh Dahiya, Ganesh Aswath, Daryl Ramai, Marcello Maida, Andrea Anderloni, Nicola Muscatiello and Antonio Facciorusso
J. Clin. Med. 2024, 13(18), 5627; https://doi.org/10.3390/jcm13185627 - 22 Sep 2024
Cited by 2 | Viewed by 3053
Abstract
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have become one of the most popular medications for patients with diabetes and obesity. Due to their effects on gut motility via central or parasympathetic pathways, there have been concerns about an increased incidence of retained gastric [...] Read more.
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have become one of the most popular medications for patients with diabetes and obesity. Due to their effects on gut motility via central or parasympathetic pathways, there have been concerns about an increased incidence of retained gastric contents and risk of aspiration in the perioperative period. Hence, the American Society of Anesthesiologists (ASA) recommends holding GLP-1 RAs on the procedure day or a week before the elective procedure based on the respective daily or weekly formulations, regardless of the dose, indication (obesity or diabetes), or procedure type. On the contrary, the American Gastroenterological Association (AGA) advises an individualized approach, stating that more data are needed to decide if and when the GLP-1 RAs should be held prior to elective endoscopy. Several retrospective and prospective studies, along with meta-analyses, have been published since then evaluating the role of GLP-1 RAs in patients scheduled for endoscopic procedures. In this review, we discuss the current clinical guidelines and available studies regarding the effect of GLP-1 RAs on GI endoscopies. Full article
(This article belongs to the Special Issue Clinical Advances in Endoscopic Ultrasound-Guided Diagnosis and Treatment)
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13 pages, 3416 KiB  
Review
EUS-Guided Vascular Interventions: Recent Advances
by Sahib Singh, Saurabh Chandan, Sumant Inamdar, Kambiz S. Kadkhodayan, Jahnvi Dhar, Jayanta Samanta and Antonio Facciorusso
J. Clin. Med. 2024, 13(16), 4835; https://doi.org/10.3390/jcm13164835 - 16 Aug 2024
Viewed by 1951
Abstract
Endoscopic ultrasound (EUS)-guided vascular interventions were first reported in 2000 in a study that evaluated the utility of EUS in sclerotherapy of esophageal varices. Currently, gastric variceal therapy and portosystemic pressure gradient (PPG) measurements are the most widely utilized applications. Ectopic variceal obliteration, [...] Read more.
Endoscopic ultrasound (EUS)-guided vascular interventions were first reported in 2000 in a study that evaluated the utility of EUS in sclerotherapy of esophageal varices. Currently, gastric variceal therapy and portosystemic pressure gradient (PPG) measurements are the most widely utilized applications. Ectopic variceal obliteration, splenic artery embolization, aneurysm/pseudoaneurysm treatment, portal venous sampling, and portosystemic shunt creation using EUS are some of the other emerging interventions. Since the release of the American Gastroenterological Association (AGA)’s commentary in 2023, which primarily endorses EUS-guided gastric variceal therapy and EUS-PPG measurement, several new studies have been published supporting the use of EUS for various vascular conditions. In this review, we present the recent advances in this field, critically appraising new studies and trials. Full article
(This article belongs to the Special Issue Clinical Advances in Endoscopic Ultrasound-Guided Diagnosis and Treatment)
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