Endoscopic Ultrasound (EUS)
Physicians use endoscopic ultrasound (EUS) to identify the nature and extent of diseases of the digestive tract, chest and abdomen. Standard endoscopic procedures only provide a view of the inner lining of the digestive tract. In contrast, endoscopic ultrasound provides high resolution images of the deeper layers of the digestive tract and the surrounding organs of the chest and upper abdomen. This allows extremely accurate measurement of the extent of digestive cancers (staging). Cancer involving organs deep within the chest or abdomen, such as lymph nodes and the pancreas, can be diagnosed by guiding a needle, known as fine needle aspiration (FNA), into the tumor and removing cells for tests.
How Does EUS Work?
EUS involves passing a thin, flexible tube (endoscope) through the mouth or anus. A small ultrasound probe in the endoscope produces sound waves that create a viewable image of surrounding tissues and organs. Physicians use EUS to examine the lining and walls of the upper and lower gastrointestinal tract and nearby organs such as the pancreas, liver and gallbladder. When combined with fine-needle aspiration (FNA), EUS is a minimally invasive, state-of-the-art alternative to exploratory surgery to remove tissue samples from organs within the abdomen and chest.
ERCP- Endoscopy of the pancreas and bile ducts
ERCP is an endoscopic technique for the diagnosis and treatment of diseases of the bile ducts and pancreas. An ERCP can be helpful when there is blockage of the bile ducts by gallstones, tumors, scarring or other conditions that cause obstruction or narrowing (stricture) of the ducts. ERCP is also useful in assessing causes of pancreatitis (inflammation of the pancreas). Problems with bile ducts or pancreas most often initially cause pain, jaundice and /or weight loss.
An endoscope – a thin, flexible tube with a tiny video camera and light on the end – is introduced through the mouth and further advanced into the small intestine. Through the endoscope the physician injects a dye into the biliary ducts for an X-ray view of the bile ducts, pancreas and gall bladder.
Photodynamic Therapy (PDT)
Photodynamic therapy (PDT) is a treatment that uses a photosensitizing drug and laser light to kill cells, usually cancer cells. PDT provides a means for the elimination of superficial cancers and precancerous lesions of the digestive tract. This technique is frequently used on patients who have Barrett's esophagus or esophageal cancer. PDT involves two steps. First, a drug is administered intravenously. The drug is absorbed into the cancer cells. Approximately two days later, an endoscope is inserted into the digestive tract. Once inserted, the doctor shines a specific kind of laser light onto the diseased tissue. The combination of the laser and the drug destroys the cancer cells. PDT can be used alone or in conjunction with other treatments, such as chemotherapy or radiation therapy.
Endoscopic Mucosal Resections (Mucosectomy)
Endoscopic mucosal resection provides a non-surgical means for the removal and eradication of superficial cancers and precancerous lesions of the digestive tract. This technique is most often used in patients with Barrett’s esophagus or esophageal cancer. An endoscope, a thin, flexible tube with a tiny video camera and light on the end, is introduced through the mouth and further advanced to the site of abnormal tissue. Cancers of the digestive tract and precancerous lesions arise from the inner lining of the esophagus, stomach and intestines. The specialized technique of endoscopic mucosal resection allows the removal of this inner lining. The cancerous and precancerous tissue is shaved off of the surface of the digestive tract. In appropriately selected patients, this outpatient procedure allows you to return home the same day as your procedure and provides an attractive alternative to extensive surgical interventions that require a hospital stay. Endoscopic mucosal resection (mucosectomy) is often combined with photodynamic therapy to provide optimal results.