Arquivos de Gastroenterologia (Oct 2024)

III BRAZILIAN CONSENSUS STATEMENT ON ENDOSCOPIC ULTRASOUND

  • Ricardo Rangel de Paula PESSOA,
  • Alexandre Moraes BESTETTI,
  • Victor Lira de OLIVEIRA,
  • Wladimir Campos de ARAUJO,
  • Simone GUARALDI,
  • Rodrigo Roda RODRIGUES SILVA,
  • Francisco Antonio Araujo OLIVEIRA,
  • Maria Sylvia Ierardi RIBEIRO,
  • Fred Olavo Aragão Andrade CARNEIRO,
  • Marco Aurélio D’ASSUNÇÃO,
  • Bruno Frederico Oliveira Azevedo MEDRADO,
  • Felipe Alves RETES,
  • Gustavo Andrade de PAULO,
  • Nutianne Camargo SCHNEIDER,
  • Lucio Giovanni Battista ROSSINI,
  • Leonardo VALLINOTO,
  • Jose Celso ARDENGH,
  • Djalma Ernesto COELHO NETO,
  • Edson IDE,
  • Marcos Clarencio Batista SILVA,
  • Matheus Cavalcante FRANCO,
  • Sergio Eiji MATUGUMA,
  • Diogo Turiani Hourneaux de MOURA,
  • Vitor Nunes ARANTES,
  • Rafael NAHOUM,
  • Vitor Ottoboni BRUNALDI,
  • Marcos Eduardo Lera dos SANTOS,
  • Dalton Marques CHAVES,
  • Otávio MICELLI-NETO,
  • Bruno Chaves SALOMAO,
  • Fauze MALUF-FILHO,
  • Gustavo de Oliveira LUZ

DOI
https://doi.org/10.1590/s0004-2803.24612024-062
Journal volume & issue
Vol. 61

Abstract

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ABSTRACT Background: In the past decades, endoscopic ultrasound has developed from a diagnostic tool to a platform for many therapeutic interventions. Various technological advancements have emerged since the last Brazilian Consensus, demanding a review and update of the recommendations based on the best scientific evidence. Methods: A group of 32 renowned echoendoscopists selected eight relevant topics to be discussed to generate clinical questions. After that, a literature review was conducted to answer these questions based on the most updated evidence. Results: Thirty-three statements were formulated and voted on by the experts to reach a consensus. The Oxford System was used to grade the level of evidence. Conclusion: There is moderate evidence to support that the needle shape, gauge, or aspiration technique does not influence the yield of endoscopic ultrasound (EUS)-guided tissue sampling of pancreatic solid lesions. There is moderate evidence to support using EUS-TTNB of the cyst wall to differentiate between mucinous and non-mucinous cystic neoplasms. There is little evidence to support the EUS-guided treatment of gastric varices. There is a high level of evidence to support that EUS-guided biliary drainage and ERCP present similar outcomes in patients with distal malignant biliary obstruction. There is a high level of evidence for using EUS to diagnose neoplastic pancreatic cysts and detect necrosis before indicating drainage. There is moderate evidence to support EUS-GE over duodenal stent for malignant gastric outlet obstruction in patients with a life expectancy higher than 2 months. There is a high level of evidence to support the use of RFA in treating both functioning and non-functioning types of NET.

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