Manipal Journal of Medical Sciences


Endoscopic Ultrasound (EUS) has been used to diagnose benign and malignant Hepato-Pancreato-Biliary (HPB) conditions for over 20 years. EUS allows close access to pancreas, gall bladder, left lobe of the liver and bile duct. In particular, it is possible to sample these and other retroperitoneal tissue safely. With the introduction of novel fork-tip and Franssen type cutting needles, the diagnostic yield has improved significantly to greater than 95%. Hence, it has become the investigation of choice for pancreatic pathology. Contrast Enhanced EUS (CE-EUS) may help differentiating malignant tumours from slow growing tumours such as neuroendocrine tumours and inflammatory lesions. In addition, linear EUS has been used in a wide range of therapeutic procedures such as drainage of pancreatic fluid collections, gall bladder empyema, biliary drainage, treatment of pancreato-biliary tumours and coeliac plexus block/neurolysis for pain control. In this review, we will review the diagnostic and therapeutic use of EUS in HPB conditions