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Endosc Ultrasound. 2019 Jan-Feb;8(1):3-16. doi: 10.4103/eus.eus_54_18.

What should be known prior to performing EUS?

Author information

1
Medical Department 2, Caritas-Krankenhaus, Uhlandstr 7, D-97980 Bad Mergentheim, Germany; Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
2
Pancreatico/Biliary Endoscopy & Endosonography Division, Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute, Vita Salute San Raffaele University, Milan, Italy.
3
Translational Gastroenterology Unit I John Radcliffe Hospital I Oxford OX3 9DU, UK.
4
Surgical Gastroenterology unit, Groote Schuur Hospital, Cape Town, South Africa.
5
Humanitas Clinical and Research Center- IRCCS- Digestive Endoscopy Unit, Division of Gastroenterology, Rozzano, Milan, Italy.
6
Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
7
Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China.
8
Department of Medical and Surgical Sciences, Gastroenterology Unit, University of Bologna/Imola Hospital, Imola, Italy.
9
National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen and Department of Clinical Medicine, University of Bergen, Bergen, Norway.
10
General and HPB Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK.
11
Medical Department, Helios Klinikum Meiningen, Germany.
12
Department of Gastroenterology, Allgemeines Krankenhaus Celle, Celle, Germany.
13
Department of Gastroenterology and Hepatology, Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
14
Medical Department 2, Caritas-Krankenhaus, Uhlandstr 7, D-97980 Bad Mergentheim, Germany.
15
Department of Hepatology and Gastroenterology, Charite CCM, Berlin, Germany.
16
Department of Gastroenterology, The State University of New Jersey, New Jersey, USA.
17
Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
18
Department of Surgical Gastroenterology, Aarhus University Hospital, Aarhus, Denmark; Department of Surgery and Department of Advanced Interventional Endoscopy, University Hospital Brussels, Brussels, Belgium.
19
Digestive Endoscopy Unit, IRCCS Foundation University Hospital, Policlinico A. Gemelli, Rome, Italy.
20
Medical Department I/Gastroenterology, SANA Hospital Lichtenberg, Berlin, Germany.
21
Digestive Endoscopy Unit, Hopital Privé J Mermoz Ramsay Générale de Santé, Lyon, France.
22
HPB Unit, Freeman Hospital, Newcastle upon Tyne, UK.
23
Department of Gastroenterology, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy of Craiova, Craiova, Romania.
24
Interventional Gastroenterology, Institute of Digestive and Hepatobiliary Sciences Medanta the Medicity, Gurugram, Haryana, India.
25
Center Hospitalier de l'Université de Montréal, Montreal, Canada.
26
Department of Gastroenterology and Liver Diseases, Tel Aviv, Sourasky Medical Center, Tel Aviv, Israel.
27
Department of Gastroenterology, Jaswant Rai Speciality Hospital, Meerut, Uttar Pradesh, India.
28
Endosonography and advanced therapeutic endoscopy, Division of Gastroenterology, The American University of Beirut, Medical Center, Beirut, Lebanon.
29
Endoscopy Center, ShengJing Hospital of China Medical University, Shenyang, Liaoning, China.
30
Division of Upper Gastrointestinal and Metabolic Surgery, Department of Surgery, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
31
GastroUnit, Department of Surgery, Copenhagen University, Hospital Herlev, Denmark.
32
Department of Internal Medicine, Krankenhaus Maerkisch-Oderland, D-15344 Strausberg and Brandenburg Institute of Clinical Ultrasound at Medical University Brandenburg, Germany.

Abstract

Direct referral of patients for EUS - instead of preprocedural consultation with the endosonographer - has become standard practice (like for other endoscopic procedures) as it is time- and cost-effective. To ensure appropriate indications and safe examinations, the endosonographer should carefully consider what information is needed before accepting the referral. This includes important clinical data regarding relevant comorbidities, the fitness of the patient to consent and undergo the procedure, and the anticoagulation status. In addition, relevant findings from other imaging methods to clarify the clinical question may be necessary. Appropriate knowledge and management of the patients' anticoagulation and antiplatelet therapy, antibiotic prophylaxis, and sedation issues can avoid unnecessary delays and unsafe procedures. Insisting on optimal preparation, appropriate indications, and clear clinical referral questions will increase the quality of the outcomes of EUS. In this paper, important practical issues regarding EUS preparations are raised and discussed from different points of view.

KEYWORDS:

Coagulation tests; EUS; cost-effective; sedation

PMID:
30777940
DOI:
10.4103/eus.eus_54_18
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