Therapeutische Endosonographie des Gastrointestinaltrakts

Due to the growing expertise in performance of high-quality diagnostic endoscopic ultrasound (EUS) examinations and the wide availability of therapeutic longitudinal echoendoscopes with a large instrumentation channel, the preconditions have been created to perform EUS-guided interventions with therapeutic intent on a regular basis. Meanwhile the spectrum of methods has expanded greatly and is increasingly being taken into account in the algorithms of current guidelines. This article provides an overview of indications and recommendations for general technical approaches to the most common directly EUS-guided therapeutic interventions. These include EUS-guided drainage of peripancreatic fluid collections, EUS-guided biliary drainage, EUS-guided gallbladder drainage, and EUS-guided gastroenterostomy. The procedures should be carried out in experienced centers within an interdisciplinary team approach to ensure safe implementation and rapid management of complications, if necessary.