Needle Specific Technical Success:
EUS-BD: defined as successful needle access and cholangiography
EUS-PD: defined as successful needle access and pancreatography
EUS-GBD: defined as successful needle access and cholecystography
Biloma: defined as successful needle access and aspiration of bilious fluid and wire deployment into the biloma.
Pseudocyst: Successful needle accessand aspiration of cystic fluid
WOPN: Successful needle accessand wire deployment with looping in the necrotic cavity
Abscess: Successful needle accessand wire deployment with looping in the abscess cavity
Tumor ablation: defined as successful accessof the tumor as seen sonographically
Fiducial placement: defined as successful needle accessof the site interest (residual tumor where visible)
Endovascular therapy: defined as successful needle access of the vessel of interest (artery or vein)
Procedural Success:
EUS-BD: defined as successful transmural stenting or balloon dilation along with the flow of contrast medium and/or bile through the stent
EUS-PD: defined as successful transmural stenting or balloon dilation along with the flow of contrast medium and/or pancreatic fluid through the stent
EUS-GBD: defined as successful transmural stenting or balloon dilation along with the flow of contrast medium and/or bile through the stent
Biloma: defined as successful transmural stenting or balloon dilation along with the flow of bilious fluid through the stent
Pseudocyst: defined as successful transmural stenting or balloon dilation along with the flow of cystic fluid through the stent.
WOPN: defined as successful transmural stenting or balloon dilation along with the flow of necrotic material through the stent
Abscess: defined as successful placement of at least one endoprostheses +/- drainage catheter/s through the transmural tract.
Tumor ablation: defined as successful delivery of agent (TNFerade, ethanol, cytoimplant, chemotherapy) as confirmed on endosonographic views.
Fiducial placement: defined as successful deployment of fiducial markers into the pancreas.
Endovascular therapy: defined as successful deployment of coil(s) and/or glue or other substance into the vessel as confirmed on endosonographic views.
Clinical Success
EUS-BD: defined as a decrease of cholestatic indices to less than 75% of pretreatment value or to within normal limits within one month of the procedure.
EUS-PD: defined as pain relief with a maximum score of 3/10 on the pain scale at 1 month after drainage.
EUS-GBD: defined as resolution of acute cholecystitis.
Biloma: Complete resolution of the cavity cavity at 2 weeks on CT scan along with symptom improvement.
Pseudocyst: defined as complete resolution, or a decrease in size of the pseudocyst to ≤2 cm on CT in association with clinical resolution of symptoms at 6-week follow-up.
WOPN: defined as resolution of symptoms (fevers, pain etc) and complete resolution or a decrease in size of the fluid collection to <3cm. Repeat endoscopic interventions for debridement were not considered as failure. However, any alternative interventions being employed (surgical drainage, percutaneous drainage) would result in failure.
Abscess: Complete resolution of the abscess cavity at 2 weeks on CT scan along with symptom improvement.
Tumor ablation: defined as complete eradication of the tumor as seen sonographically and a decrease in tumor marker/s. This could be achieved with single or repeated injection.
Fiducial placement: defined as fiducials being identified in appropriate location on CT simulation or other pre-radiotherapy simulation
Endovascular therapy: defined as no clinical bleeding from the region of interest at 6 months follow up. This could be achieved with single or repeated injection.
Adverse Events:
Wire shearing
Infection– cholangitis, cholecystitis, fever, sepsis
Bleeding – acute, delayed (>24hrs), intraluminal, extraluminal
Unintentional perforation– pneumoperitoneum, bile leak, biliary peritonitis, non-biliary peritonitis
Pancreatitis
Pain– acute/delayed
Non-specific GI symptoms– vomiting
Anesthetic related – respiratory distress, arrhythmia, hypotension
Stent - migration, obstruction
Endovascular therapy– embolization