Endoscopic retrograde cholangiopancreatography (ERCP) is the primary intervention for malignant distal biliary obstruction (MDBO). However, ERCP may fail for various reasons, requiring alternative interventions such as EUS-guided biliary drainage. Among EUS-guided biliary drainage (EUS-BD) methods, EUS-guided gallbladder drainage (EUS-GBD) is emerging as a viable option for patients who have failed ERCP and EUS-BD. The aim of this study is to evaluate the efficacy and safety of EUS-GBD as salvage therapy for MDBO and its potential role in allowing the initiation of chemotherapy.

EUS-guided portal pressure gradient (EUS-PPG) measurement has been proposed as a novel direct manometry to quantify portal hypertension. This study aimed to explore the ability of EUS-PPG measurements to evaluate the severity of portal hypertension.

There are two different endoscopic ultrasonographic manifestations of gastric signet ring cell carcinoma (GSRCC). No studies have been reported on the differences in the clinical profiles of patients based on EUS examination. We aim to study the variations in clinicopathological characteristics between two distinct endoscopic ultrasonographic manifestations of GSRCC.

Recurrence of benign bilioenteric anastomotic strictures (BAS) is common after enteroscopy-assisted endoscopic retrograde cholangiopancreatography (ERCP), percutaneous intervention, or EUS-guided antegrade intervention (EUS-AI). This study evaluated the long-term outcomes of EUS-AI with transmural and transanastomotic stenting (TAS) following EUS-guided hepaticogastrostomy (HGS) in BAS.

According to previous reports, EUS-fine-needle biopsy (FNB) with or without rapid on-site evaluation (ROSE) showed the nonsuperiority of EUS-FNB + ROSE over EUS-FNB. However, previous studies included various kinds of FNB needle. This might be a critical limitation due to heterogeneity. Therefore, the aim of the present multicenter, randomized controlled trial was to compare the diagnostic accuracy of the fork-tip needle with or without ROSE for pancreatic lesions.

Sulfur hexafluoride is an inert gas that creates microbubbles to enhance diagnostic accuracy in a variety of ultrasound (US) studies and is widely used in EUS. We analyzed the reported adverse events (AEs) of the US contrast agent, sulfur hexafluoride, extensively used during EUS procedures using a US national database.

Although the impact of biliary stents on the accuracy of EUS-guided tissue acquisition (EUS-TA) is still controversial, the influence of biliary-pancreatic double stents on EUS-TA is even more inconclusive. The aim of the study was to determine whether the diagnostic yield of EUS-FNA in the diagnosis of solid pancreatic lesions will be affected after placement of biliary-pancreatic double stents.

Chronic liver inflammation leads to fibrosis and cirrhosis. To avoid portal hypertension-related complications, fibrosis' early detection is imperative. Biopsy remains the gold standard, but magnetic resonance elastography (MRE) and EUS-guided elastography are noninvasive procedures currently used for liver stiffness measurement (LSM). Two-dimensional EUS-guided shear-wave elastography (EUS-SWE) represents a more-every-day used technique.The aim of this study is to correlate LSM determined by vibration-controlled transient elastography (VCTE) and EUS-SWE and determine the measurements' accuracy in diagnosing cirrhosis.

Pancreatic neuroendocrine tumors (pNETs) are relatively rare and consist of 2% of the all pancreatic tumors. Although some of pNETs have a benign, nonprogressive course, some may be progressive and result with metastasis. We aimed to estimate the grade of pNETs by using artificial intelligence (AI) via deep learning (DL) algorithms as indexing to cyto/histopathological classification according to the World Health Organization 2017.

Patients with distal malignant biliary obstruction (dMBO) needing biliary drainage (BD) undergo ERCP as a first approach. EUS-guided gallbladder drainage (EUS-GBD) is now accepted as a rescue alternative for the palliation of jaundice in those patients with dMBO who fail ERCP and cannot undergo EUS-BD. This is a systematic review with meta-analysis for evaluating the efficacy and safety of EUS-GBD in this scenario. A comprehensive search through the main database platforms was conducted to May 2024. Pooled estimates were obtained using a fixed-effects model with the generic inverse variance method. Study quality was evaluated using the Newcastle-Ottawa quality assessment scale (NOS). Heterogeneity was evaluated with statistic. Clinical success, adverse events (AEs) rate, and reintervention rate were the main outcomes. Sensitivity analyses were also conducted. Eight studies including 183 patients were identified. Pooled clinical success was 89% (95% CI, 84%-93%). The pooled clinical success of full-text publication was 88% (95% CI, 83%-93%; = 0%). Reintervention rate was 8% (95% CI, 4%-12%; = 0%). The overall AE rate was 10% (95% CI, 6%-15%; = 0%). The NOS allocated moderate quality in 7 studies. In conclusion, our findings confirm that EUS-GBD in dMBO is a feasible, effective, and safe technique as rescue therapy after failure of ERCP or EUS-BD.

Recent technological advances in interventional EUS have improved EUS-guided drainage/anastomosis (EUS-D/A), yet challenges remain. This study evaluated the safety and feasibility of a square flare fully covered self-expandable metallic stent (SF-FCSEMS) with anti-migration properties for EUS-D/A.