Indications de la biopsie guidée par échoendoscopie dans les pathologies hépatiques
Indications of EUS-FNA in liver diseases
Endosonography (EUS) constitutes an essential tool for the staging of gastrointestinal and pulmonary cancers. The study of the hepatic parenchyma can modify the therapeutic strategy by the diagnosis of infracentimetric lesions not visualized on the radiological examinations. If the diagnosis of such lesions implies a modification of the treatment, a histological confirmation is then strictly necessary by the realization of biopsy realized under endosonographic examination (EUS FNA). Precise examination of the left lobe as well as the hepatic hilum by EUS allows to biopsy primitive or secondary liver tumours with a low morbidity when the percutaneous approach is difficult. Moreover, for some authors, the realization of EUS-FNA is useful in the event of contraindication for the percutaneous route (ascitis, coagulopathy), but this indication has to be confirmed by further clinical studies.
E. BORIES, Ch. PESENTI, Geneviève MONGES, B. LELONG, F. VIRET, M. GIOVANNINI
cholangiocarcinoma, endoscopic ultrasonography (EUS), fine needle aspiration (FNA), hepatocarcinoma, liver, metastasis, oncology