11 dr yim english interventional eus

Endoscopic Ultrasound EUS Interventional EUS Dr Yim Heng Boon Adj Asst Professor Mount Elizabeth Novena Hospital Singapore Pentax EG-3870 UTK Scope width 12.8mm Accessory channel 3.8mm Slim Linear EG 3270UK Scope width 10.8mm Accessory channel 2.8mm EUS ultrasound scanners Avius Preirus Ascendus EUS FNA Forward viewing linear EUS scope • Used to drain pseudocysts • Axial application of force (easier?) • 3.7mm channel • No forceps elevator • Narrow imaging range • Further studies needed on this • TGF-UC180J EUS guided coeliac plexus neurolysis EUS guided CPN • Chemical splanchnicectomy of coeliac plexus which ablates afferent nerve fibres that transmit pain from intra-abdominal viscera • Can be performed percutaneously, surgically or under EUS EUS guided CPN • Most direct access to the coeliac plexus of all the techniques • Coeliac ganglia located at origin of coeliac artery (latter easily visualised) • Right and left coeliac ganglia commonly located 6mm and 9mm inferior to the artery takeoff EUS cysto-gastro/duodenostomy • Puncture can be done with: • Needle knife • Cystostome • EUS FNA needle • Dilatation of track with: • Push dilator, cystotome, balloon dilatation • Stent: • Plastic stents, pigtail stents, SEMS EUS guided necrosectomy for WON EUS Surgical P value Acute adverse effects 37% 71%