Endoscopic Ultrasound

Interventional Gastroenterology

The significance of the team work between the gastroenterologist and the surgeon of the digestive system is more than obvious. Colonoscopy, Esophagogastroscopy, and ERCP are endoscopic procedures widely performed. Here, we will delineate the more advanced and modern role of the very experienced gastroenterologist, above and beyond the procedures mentioned above. Nevertheless, such advanced procedures belong to our everyday practice and are crucial to the quality of our work.

1. Endoscopic Ultrasonography (EUS). Today, EUS is of paramount importance for the correct staging and thus the most appropriate design of the optimal treatment strategy in several cancers of the digestive tract. In addition, EUS is much more accurate (than CT or MRI) in delineating very important anatomic details of some tumors and their relation to critical veins and arteries around them, their depth of penetration, the status of the lymph nodes around them, as well as the possibility of involvement of neighboring organs. EUS is also the safer way to perform the most precise biopsies. For all these reasons, EUS provides the best means the most appropriate and individualized treatment plan in several patients with abdominal tumors.

2. Pancreatic stent placement. In several patients with chronic pancreatitis, or after severe acute pancreatitis, the pancreatic duct may be severely injured. Traditionally, major operations were required for treatment of such abnormalities and their complications. However, today, our very experienced interventional gastroenterologist is able to put highly specialized within the pancreatic duct and bridge its gaps or bypass its narrow segments (stenosis, occlusion). Major operations with potential high risks can thus be avoided.

3. Ablation of precancerous lesions. Often, patients with esophagitis develop anatomic abnormalities that may lead to, or already are precancerous conditions. These precancerous lesions can be removed or destroyed using highly specialized technology and techniques, such as those implemented by our close colleagues in interventional radiology.