Usefulness of endoscopic ultrasonography with gel-immersion endoscopy for esophageal varices

Kato Tsunetaka, Hikichi Takuto, Nakamura Jun, Yanagita Takumi, Takagi Tadayuki, Otsuka Mitsuru, Noguchi Yuki, Kameoka Eisuke, Ohira Rei, Ohira Hiromasa

doi:10.11423/jsph.30.278

<p>It has been difficult to obtain good EUS images of esophageal varices (EVs) using the water-filling EUS technique. The purpose of this study was to evaluate the usefulness of gel-immersion EUS for EVs compared with water-filling EUS. We retrospectively evaluated EUS image quality, procedure time, diagnostic ability of local veins in the EVs, and adverse events in EVs patients who underwent EUS prior to endoscopic treatment. EUS image quality was rated on a 4-point scale from 4 (very good) to 1 (poor), and operators were classified as “expert” if they had more than 10 years of medical experience and “non-expert” if they had less than 10 years of medical experience. Eighteen gel-immersion-EUS and 17 water-filling EUS patients were included in this study, and there was no difference in operators between the two groups. Image quality scores were higher for gel-immersion-EUS at 4 (3-4) and water-filling EUS at 2 (1-3) (p < 0.001). Diagnostic ability of Pv was also higher with gel-immersion-EUS (p = 0.03). Procedure time was 6.5 (4-14) minutes for gel-immersion-EUS and 4 (2-10) minutes for water-filling EUS with gel-immersion-EUS (p < 0.001). No adverse events occurred in either case. gel-immersion-EUS for EVs was safe and could be performed safely with good image quality.</p><p>In conclusion, in hemodynamic diagnosis by EUS for EVs, gel-immersion-EUS provided better EUS images and better evaluation of Pv than water-filling EUS, even for non-expert operators.</p>

Usefulness of endoscopic ultrasonography with gel-immersion endoscopy for esophageal varices

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