What EUS adds
Endoscopic ultrasound places a high-frequency ultrasound transducer close to the pancreas, bile duct and surrounding structures. It can define lesions that are difficult to characterise using luminal endoscopy alone and can enable image-guided tissue acquisition.
Common HPB indications
- Pancreatic masses and suspected pancreatic cancer
- Pancreatic cystic lesions
- Selected biliary obstruction and strictures
- Subepithelial and peri-gastrointestinal lesions
- Therapeutic access in selected pancreatobiliary conditions
EUS-guided tissue acquisition
Sampling strategy is selected according to the lesion and the clinical question. ESGE guidance addresses EUS-guided sampling and tissue-acquisition techniques for pancreatobiliary disease.1
Approximate annual activity
>500 EUS procedures per year. This is an estimate of current annual clinical practice and varies from year to year.
After the procedure
Recovery depends on whether the examination was diagnostic only, whether tissue was acquired and whether an interventional procedure was performed. Specific risks and aftercare are discussed for the planned procedure.
References & clinical guidance
Clinical content on this page is original patient-facing writing informed by the cited sources; it is not reproduced from them.
EUS-guided biliary and gallbladder drainage
Therapeutic EUS may be used to achieve internal biliary drainage in selected patients when conventional ERCP is unsuccessful or unsuitable. Depending on the anatomy and indication, approaches include EUS-guided choledochoduodenostomy or hepaticogastrostomy. EUS-guided gallbladder drainage is an option for carefully selected patients with acute cholecystitis who are unsuitable for surgery, following multidisciplinary assessment. These interventions carry risks including bleeding, infection, bile leakage, perforation and stent-related complications and are not routine first-line procedures for all patients.
This information is educational and does not replace individual medical assessment. Diagnosis and treatment recommendations depend on the patient, imaging, pathology, disease stage and multidisciplinary assessment.