ASGE International Sampler (On-Demand)-Keeping an Eye on the Intervention

Video Transcription

Video Summary

The video features Dr. Shivangi Kothari, an Associate Professor of Medicine and Associate Director of Endoscopy, who discusses various interventional endoscopic ultrasound procedures. Dr. Kothari has expertise in procedures such as endoscopic ultrasound-guided pancreatic fluid collection drainage, celiac plexus blocks, fiducial placements, liver biopsies, and portal pressure measurements.<br /><br />For pancreatic fluid collection drainage, Dr. Kothari emphasizes proper patient selection, imaging review, and a multidisciplinary approach. She explains the steps involved in endoscopic transluminal drainage using double pigtail stents or lumen-opposing metal stents. In cases of necrotic fluid collections, direct entry into the cavity with endoscopic debridement may be necessary.<br /><br />Regarding celiac plexus blocks, Dr. Kothari discusses different approaches and provides guidance on performing the procedure safely. She highlights the importance of fluid hydration and using appropriate needles to minimize side effects such as hypotension.<br /><br />Dr. Kothari also discusses fiducial placements for tumor tracking during radiation therapy. She explains the techniques of backloaded or preloaded fiducial needle deployments, and the benefits of the latter in difficult cases.<br /><br />EUS-guided liver biopsies are deemed safe and minimally invasive with comparable tissue yields to other methods. Dr. Kothari provides details on the setup, needle choice, and technique for obtaining liver biopsies through EUS.<br /><br />Lastly, Dr. Kothari discusses EUS-guided portal pressure measurements, enabling direct measurement of hepatic and portal venous pressures. The procedure involves accessing the middle hepatic vein and the left portal vein to obtain pressure readings that can help evaluate portal hypertension.<br /><br />Overall, the video provides a comprehensive overview of various interventional EUS procedures and offers insights into the techniques and considerations for each.

Asset Subtitle

Carlos A. Robles Medranda, MD, FASGE and Shivangi Kothari, MD, FASGE

Keywords

interventional endoscopic ultrasound procedures

pancreatic fluid collection drainage

celiac plexus blocks

fiducial placements

liver biopsies

portal pressure measurements