Post written by Girish Mishra, MD, MS, FASGE, from the Wake Forest University School of Medicine/Atrium Health, Winston-Salem, North Carolina, USA.

The prior version of “Quality indicators for EUS” was published 10 years ago. Interventional EUS (iEUS) was only a concept back then; therapeutic interventions were limited.

We highlighted the expanding indications for EUS and provided more granularity regarding performance expectations for diagnostic EUS. For example, to perform high-quality EUS, it is not adequate to simply detect a pancreatic mass, but a high-quality EUS examination should be able to detect a mass >1 cm more than 80% of the time. The performance targets for performing EUS for an established indication were liberalized to allow for an “outside the box” indication.

Therapeutic indications were divided as (1) ductal access procedures, endohepatology procedures, luminal anastomosis procedures, and other (celiac plexus block, fiducial, or ablation). We noted the importance of expanding the informed consent process to include pivoting to EUS-guided interventions when ERCP is unsuccessful. Quality indicators 12 to 20 are largely new. Adverse events (AEs) related to iEUS also are new; performance targets for these procedures along with associated AEs are extracted from the literature.

Of all the endoscopic interventions, EUS has witnessed the greatest growth or expansion. iEUS was only a concept when the prior “Quality indicators for EUS” was written. Endosonographers performing these procedures need guidance for the indications, but, moreover, for iEUS a proscription of when to perform these procedures with an accompanying acceptable AE rate to discuss with their patients.

This society document is an enormous help for all endosonographers but definitely those performing iEUS for the reasons highlighted.

Table 4 in the article is brand new and created at the American Society for Gastrointestinal Endoscopy Governing Board’s request. This table guides the endosonographer as to when to administer antibiotics.

Read the full article online.

The information presented in Endoscopedia reflects the opinions of the authors and does not represent the position of the American Society for Gastrointestinal Endoscopy (ASGE). ASGE expressly disclaims any warranties or guarantees, expressed or implied, and is not liable for damages of any kind in connection with the material, information, or procedures set forth.