Advanced Endoscopy Fellows Program | September 2024-Chahal_Interventional EUS Video Case Presentation

Chahal_Interventional EUS Video Case Presentation

Pdf Summary

The document is a presentation on interventional endoscopic ultrasound (EUS) by Dr. Prabhleen Chahal, focusing on basic principles, common complications, and specific case studies. It emphasizes the importance of understanding the patient, ensuring proper indications, obtaining thorough informed consent, and maintaining transparent communication. The text highlights the necessity of having a competent procedural team and being prompt in response and investigation of alarm symptoms.<br /><br />Complications associated with interventional EUS include bleeding (1-10%), stent migration (2-8%), stent occlusion (0-10%), perforation (0-4%), air embolism (1%), and delayed bleeding or buried stent (3-6.5%). Key points for managing bleeding involve reviewing imaging for varices and collaterals, using endoscopic tools like clips and cautery, and being vigilant with procedural techniques.<br /><br />Stent migration is another complication, with key management strategies including the use of fluoroscopy-equipped rooms, considering the anatomical context (e.g., difficult locations like the cardia or close to the gastroesophageal junction), and appropriate timing for stent removal. Internal migration may cause more harm and require surgical retrieval.<br /><br />The document presents a specific case of a 50-year-old male with alcohol-induced pancreatitis and pseudocyst, discussing stent management and the timing of removal. It also outlines steps to prevent buried stents, such as early removal and maintaining logs for recall.<br /><br />Key points for managing gallbladder-related interventions include avoiding the gallbladder neck, selecting appropriate stent sizes, and careful coordination during procedures. Specific recommendations for stent sizes and cautionary tips are provided.<br /><br />The document wraps up with essential traits for a successful endoscopic career: attention to detail, composure under stress, self-confidence, lifelong learning, situational awareness, and clear communication. These principles and practical guidelines aim to enhance procedural success and patient safety in interventional EUS.

Keywords

interventional endoscopic ultrasound

Dr. Prabhleen Chahal

EUS complications

stent migration

bleeding management

gallbladder interventions

case study

patient safety

procedural team

communication