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therapeutic EUS biliopancreatic looks on track
The use of contrast in ERA, radio and in the approach alcoholization hepatocellular carcinoma and therapeutic endoscopy have been some of the topics discussed at an international symposium held on digestive ultrasonography in the Hospital La Paz, Madrid.
Joseph A. Plaza - Wednesday, March 23, 2011 - Updated at 00:00 pm Just
, Garre and Mora, in one of the corridors of the Hospital La Paz. ()
Hospital La Paz has celebrated the 25th anniversary of his course on digestive ultrasonography and, to commemorate the silver anniversary, organized an international symposium to discuss the current status and the significant growth in this area. The aim was to address the "topical issues, cutting edge, and basic to catch up in a rapidly changing field," as pointed Carmen Garre, president of the scientific committee of the English Association of Digestive Ultrasonography (EYES), who highlighted the presence of Marc Giovannini, Institute Paoli-Calmettes in Marseille, France. Giovannini
is one of the few authors who have published relevant on the use of contrasts in inflammatory bowel disease (IBD), as explained by Peter Mora, La Paz and one of the organizers, together with José María Segura " The contrasts can differentiate whether the IBD is also the inflammatory component of acute outbreaks, symptoms fibrotic. The distinction is simple, as the area that is fibrotic is not vascularized and not filled contrast, the very opposite of the mucosa, which itself is full when there is edema and inflammation.
alcoholization Radiofrequency and techniques are complementary and can be combined in the resection of hepatocellular
Thus, the contrasts aid in the diagnosis of IBD, but also the patient's treatment: "If there is no inflammatory component and yes stenosis, may have to think about drying the stenotic area. If the area has inflammatory properties should go to drug treatment to reduce inflammation. " Percutaneous ablation
Garre referred to the use radio frequency and local therapies alcoholization as primitive liver tumors, mainly in cases of hepatocellular carcinoma: "This is local with metastasized tumors very late, and curative treatment. But what is the cancer cure, not the liver itself , already affected by tumor, it may recur liver tumors in other regions. "
To prevent these relapses compromise the patient's life, every three months a review ultrasound to detect when its size is still very small. That's when the radio or alcoholization (radiofrequency catheter ablation in both cases) "achieve 90 percent complete necrosis of tumors.
Hepatocarcinoma doubles in size in a time of three to six months. If detected early, it is possible to necrosis, which is a great advantage if the patient spends several months in list waiting for a transplant.
The specialist, who belongs to the Hospital Virgen de La Arrixaca, Murcia, believes that the radio frequency techniques alcoholization are different, even complementary, sometimes used in combination. Supports the invasiveness of both although specific radio frequency that can bring more complications. To his credit, Mora notes that "are very selective and specific, because it just click on the node." His use depends in part on the location of the tumor, since, for example, if vessels are nearby, the heat can damage nearby structures. In this sense, Garrett adds that, although both provide very good results, must take into account the particular situation: "For example, if the location is the caudate lobe never opt for the Radio Frequency alcoholization always." Progress
percutaneous
As explained Garre and Mora, whose opinion was joined José Just, president of the EYES, therapeutic EUS is clearly the future: "For every day percutaneous detect more things. With EUS it goes further and therapeutic level with endoscopic retrograde cholangiopancreatography (ERCP) and other techniques, the development will be very important in the short term. "
According to Just," based interventional endoscopic ultrasound is a very interesting union . EUS is indicated to work on those areas where ultrasound difficult to reach, especially in the biliary intervention. In the study punctures and lesions in the pancreatobiliary area is where more and better instruction can be. "Prosthetics and their drains are other application areas. According to Mora," and pancreatic drainage are almost always by endoscopic ultrasonography.
A complex learning
The EUS is a complex technique that requires knowledge of both endoscopy and ultrasound. As explained specialists, as happens with ERCP, is a time for learning and "can do less exploration, because in a week can only be 3 or 4, when, for example, it is possible to carry out 14 or 15 grastroscopias. With EUS, unlike other techniques, learning proceeds slowly because "there is so much volume of disease and hardship."
therapeutic EUS looks at the way BPD - DiarioMedico.com
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