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Endoscopic ultrasonography as a therapeutic modality

Khashab, Mouen A.a; Varadarajulu, Shyamb

Current Opinion in Gastroenterology: September 2012 - Volume 28 - Issue 5 - p 467–476
doi: 10.1097/MOG.0b013e32835672b4
ENDOSCOPY: Edited by Anthony N. Kalloo

Purpose of review Endoscopic ultrasonography (EUS) has taken on more of a therapeutic role in recent years. This review will focus on the therapeutic applications of EUS.

Recent findings Multiple studies on the therapeutic applications of EUS have been published. EUS facilitates endoscopic drainage of pancreatic fluid collections (PFCs) including walled-off pancreatic necrosis, management of refractory gastrointestinal bleeding from gastric varix or vasculature by fine-needle injection and decompression of obstructive pancreatic or biliary ductal systems following failed access by standard endoscopic or radiological techniques.

Summary The indications and role of therapeutic EUS have expanded rapidly in recent years. The procedures can be technically challenging, requiring expertise in both endosonography and endoscopic retrograde cholangiopancreatography. Refinement in echoendoscope design and dedicated accessories are required to further expand the applications of therapeutic EUS.

aDivision of Gastroenterology and Hepatology, Department of Medicine, The Johns Hopkins Medical Institutions, Baltimore, Maryland

bDivision of Gastroenterology and Hepatology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA

Correspondence to Mouen A. Khashab, MD, Assistant Professor of Medicine, Director of Therapeutic Endoscopy, Johns Hopkins Hospital, NCB/Zayed Tower, 1800 Orleans Street, Suite 7125B, Baltimore, MD 21205, USA. Tel: +1 443 287 1960; fax: +1 443 683 8335; e-mail:

© 2012 Lippincott Williams & Wilkins, Inc.