Clinical impact of high-definition endoscopic ultrasonography (EUS) in a district hospital

Rev Esp Enferm Dig. 2010 Dec;102(12):698-703. doi: 10.4321/s1130-01082010001200004.

Abstract

Objectives: Evaluation of the impact of EUS in clinical practice.

Methods: All exploration performed during the first 18 months of implementation of the technique were analyzed. Agreement was assessed by radiographic techniques or surgical specimens in those cases allowed.

Results: 277 exploration were performed. There have been only 2 complications and they were related to sedation in both cases. The demand increased gradually, reaching 70 scans per 100,000 inhabitants. Main indications were bile (34.3%) and pancreatic processes. No pathology was found in 10% of cases; 29 cases had choledocholithiasis (93% confirmed and treated endoscopically). Chronic pancreatitis was diagnosed in 19 cases (only 15.78% of the cases were diagnosed by computed tomography). 32 patients with idiopathic acute pancreatitis were evaluated: 20 of them had evidence of microlithiasis (80% cholecystectomized and asymptomatic after a mean follow-up of 21.5 months), two cases of choledocholithiasis, 1 with chronic pancreatitis and 9 cases remained free of filial etiology. We performed 56 punctures: 39 samples of pancreas in 33 patients (81.1% of the samples were diagnostic; adenocarcinoma and serous cystadenoma were the most common diagnoses), 13 enlarged nodes and 4 abdominal masses.

Conclusions: EUS is a growing demand technique that has low risks and leads to better decision-making in a significant number of patients with different diseases. Therefore, its inclusion in routine clinical practice must be considered.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Endosonography* / statistics & numerical data
  • Female
  • Gastrointestinal Diseases / diagnosis
  • Gastrointestinal Diseases / diagnostic imaging*
  • Gastrointestinal Diseases / pathology
  • Gastrointestinal Neoplasms / diagnosis
  • Gastrointestinal Neoplasms / diagnostic imaging
  • Hospitals, District
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Reproducibility of Results
  • Young Adult