SP Misra moderated the session conducted on pancreato-biliary diagnosis. The talking points of the session consisted of evaluation of mass lesion in chronic pancreatitis, EUS for hilar and sub-hilar lesions, EUS for unexplained dilated CBD and many more.
SP Misra, Professor head, gastroenterology president of GI society of India and past president of Indian Society of gastroenterology said, “The session was based on EUS in pancreatic diseases. The discussion was about the role of EUS in undiagnosed patients having dilated common bile duct and in pancreatic masses and in chronic pancreatitis.”
He added, “Although, EUS is diagnosed in most of the cases. But all the cases don’t get diagnosed. EUS has a good role in evaluating most of the patient’s, but not all patients. Patients should remember that there is nothing 100% in medical science. No outcome or diagnosis is 100%. So we have to wait followup these patients. But science is progressing and we are getting new modalities of diagnosis and therapy, everyday.”
I Waxman, Prof and chief section of gastroenterology Department of Medicine, University of Chicago, Chicago USA informed, “Despite the excellent results of multidetector CT and MRI with MRCP in routine, EUS with EUS guided Fine Needle Aspiration (FNA) remains indispensable for optimal management patients with a pancreatic solid lesion. Moreover, there is a need for good level of endosonographers in pancreatic teams. CH-EUS, elastography and EUS-guided histology are of great help in this field.”
Amrita Sethi, University of Columbia, New York Presbyterian hospital, USA said, ” EUS FNA has a prominent role in the evaluation of hilar/ subhilar lesions, should be considered in initial evaluations. EUS FNA has approximately 80% sensitivity for CCA, higher for distal lesions and better than CT and MR as per some studies. Yields of EUS FNA for CCA may outweigh prior concerns for tumor seeding.”
Though this session, the message given to the doctors was that the EUS has gained tremendous popularity and all of us should be trained in the same. Hopefully, the machines will become cheaper because of competition. The government should do take a note of it, so that EUS is available at the taluka and district hospitals.