Experiences and Perspectives on Endoscopic Ultrasound for the Diagnosis and Treatment of Pancreatic Diseases: A Rapid Qualitative Review [Internet]

Endoscopic ultrasound (EUS) can play an important role in the diagnosis and treatment of suspected pancreatic diseases. EUS is a procedure where a device called an echoendoscope is passed through the esophagus, stomach and duodenum to take pictures of the gastrointestinal tract including the pancreas. The echoendoscope is a thin tube with a light, a camera, and an ultrasound transducer on its tip and can provide camera and ultrasound images. The images can be very detailed and provide information on pancreatic tumours, lesions and cysts.Patients often are referred to undergo an EUS after having another form of radiographic imaging such as an MRI, CT scan, or an abdominal ultrasound. EUS is typically done by a gastroenterologist and an anesthesiologist as an outpatient procedure in specialized setting. The procedure is done while patients are under sedation, and there is a small risk of potential complications, including bleeding, perforation, infection and acute pancreatitis.When EUS is combined with fine needle aspiration (EUS-FNA), a tissue sample can be collected. This can provide further information on the staging and grading of cancer. Additionally, EUS-FNA techniques can be combined with other procedures for example to insert stents into the pancreatic duct and drain fluid for the treatment of chronic pancreatitis, and also as a first-line therapy for pancreatic cancer.Within some Canadian jurisdictions, access to EUS remains limited outside of urban specialist facilities. In considering expanded access to, and the role of, EUS for people with pancreatic diseases, there is a need to understand the perspectives of those with suspected or confirmed pancreatic diseases. This report aims to address this need by providing insight using qualitative studies on how people with suspected or confirmed pancreatic disease experience accessing, deciding on, and undergoing diagnostic EUS and potential treatment using EUS. Given that EUS is situated in a care pathway that includes other diagnostic and treatment options, this report looks at the broader care pathway for pancreatic diseases.