Review
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World J Gastroenterol. Aug 7, 2014; 20(29): 9976-9989
Published online Aug 7, 2014. doi: 10.3748/wjg.v20.i29.9976
Endoscopic ultrasound in the diagnosis and treatment of pancreatic disease
Christopher W Teshima, Gurpal S Sandha
Christopher W Teshima, Gurpal S Sandha, Division of Gastroenterology, University of Alberta, Edmonton, Alberta T6G 2X8, Canada
Author contributions: Teshima CW designed the research; Teshima CW and Sandha GS performed the literature review and analyzed the data; Teshima CW and Sandha GS drafted the article, revised it critically, and approved the final version of the manuscript.
Correspondence to: Christopher W Teshima, MD, MSc (Clin Epi), PhD, FRCPC, Assistant Professor, Division of Gastroenterology, University of Alberta, 2-28 Zeidler Ledcor Centre, Edmonton, Alberta T6G 2X8, Canada. teshima@ualberta.ca
Telephone: +1-780-2481673  Fax: +1-780-4929416
Received: November 13, 2013
Revised: February 28, 2014
Accepted: April 21, 2014
Published online: August 7, 2014
Abstract

Endoscopic ultrasound (EUS) is an important part of modern gastrointestinal endoscopy and now has an integral role in the diagnostic evaluation of pancreatic diseases. Furthermore, as EUS technology has advanced, it has increasingly become a therapeutic procedure, and the prospect of multiple applications of interventional EUS for the pancreas is truly on the near horizon. However, this review focuses on the established diagnostic and therapeutic roles of EUS that are used in current clinical practice. In particular, the diagnostic evaluation of acute pancreatitis, chronic pancreatitis, cystic pancreatic lesions and solid masses of the pancreas are discussed. The newer enhanced imaging modalities of elastography and contrast enhancement are evaluated in this context. The main therapeutic aspects of pancreatic EUS are then considered, namely celiac plexus block and celiac plexus neurolysis for pain control in chronic pancreatitis and pancreas cancer, and EUS-guided drainage of pancreatic fluid collections.

Keywords: Endoscopic ultrasonography, Fine needle aspiration, Pancreatic cyst, Pancreatic neoplasms, Pancreatitis

Core tip: This is an invited review paper that provides a comprehensive review of the current diagnostic and therapeutic roles of endoscopic ultrasound in pancreatic disease.