简介：TherevisedAtlantaclassificationofacutepancreatitiswasadoptedbyinternationalconsensus,andisbasedonactuallocalandsystemicdeterminantsofdiseaseseverity.Thelocaldeterminantispancreaticnecrosis(sterileorinfected),andthesystemicdeterminantisorganfailure.Localcomplicationsofpancreatitiscanincludeacuteperi-pancreaticfluidcollection,acutenecroticcollection,pseudocystformation,andwalledoffnecrosis.Interventionalendoscopicultrasound(EUS)hasbeenincreasingutilizedinmanagingtheselocalcomplications.AfterperformingaPubMedsearch,theauthorsmanuallyappliedpre-definedinclusioncriteriaorafiltertoidentifypublicationsrelevanttoEUSandpancreaticcollections(PFCs).Theauthorsthenreviewedtheutility,efficacy,andrisksassociatedwithusingtherapeuticEUSandinvolvedEUSdevicesintreatingPFCs.Duetothedevelopmentandregulatoryapprovalofimprovedandnovelendoscopicdevicesspecificallydesignedfortransmuraldrainageoffluidandnecroticdebris(accessandpatencydevices),theauthorspredictcontinuingevolutioninthemanagementofPFCs.WebelievethatEUSwillbecomeanindispensablepartofproceduresusedtodiagnosePFCsandperformimage-guidedinterventions.AfterdrainingaPFC,theamountoftissuenecrosisisthemostimportantpredictorofasuccessfuloutcome.Hence,itseemslogicaltoclassifythesecollectionsbasedontheirpercentageofnecroticcomponentordebrispresentwhenviewedbyimagingmethodsorEUS.Finally,theauthorsproposeanalgorithmformanagingfluidcollectionsbasedontheirsize,location,associatedsymptoms,internalechogenicpatterns,andcontent.

简介：肝炎B病毒(HBV)感染是使世界范围的3.5亿个人担心的一个全球公共健康问题。有长期的肝炎B(CHB)的个人在开发肝肝硬化，肝的补偿不全和hepatocellular癌的增加的风险。为了维持，无法发现的病毒的负担减少长期的感染复杂并发症。没有治疗，根除HBV感染。当前的药是昂贵的，与不利事件被联系，并且具有有限功效。当前的指南试着标准化临床的实践。不过，争吵与CHB关于无征状的病人的管理留下，并且什么是肝炎Be抗原(HBeAg)与正常丙氨酸aminotransferase积极是病毒的负担的截止价值区分HBeAg否定的CHB病人和不活跃的搬运人。我们详细讨论DNA水平为什么独自不是足够的开始CHB的治疗。

简介：瞄准：为了为内视镜的超声(EUS)比较结果，指导了清楚的液体的排水有脓肿的结果的胰腺的pseudocysts排水。方法：所有病人参考了因为一个液体集合的内视镜的排水有希望地被包括。结果被记录。结果：总的来说26pseudocysts或脓肿在25被对待(6女性)病人。一endoscopist执行了过程。非感染的pseudocysts在15个病人是在场的，10个病人感染了液体集合。包囊尺寸在28厘米漠?桴?潢瑴敬之间变化了吗？

简介：瞄准：为了评估胰腺的织物的组织学的评估的诊断精确性，一个修改方法为恢复并且处理内视镜的超声(EUS)获得的样品指导了好针渴望(FNA)在胰腺的固体的鉴别诊断的材料集中。方法：有胰腺的群众的62个连续病人有希望地被学习。EUS被线性扫描PentaxFG-38UX回响内诊镜执行。三FNA(22G针)在每个过程期间被执行。与第一和第二根刺获得的材料为cytological学习被处理。第三根刺的材料被盐溶液的小心的注射通过针为摩尔答案恢复进10%，并且为组织学的学习处理了。结果：一些为组织学的分析获得的核心标本是6.5+/-5.3公里(范围1-22公里)。Cytological和组织学的样品在51被看作足够(82.3%)并且52个盒子(83.9%)分别地。为恶意的诊断的胰腺的细胞学和组织学的全面敏感是68.4%。与细胞学相反，组织学能诊断除煽动性的群众的腺癌，和所有情况以外的瘤。细胞学和组织学的联合允许在56种情况(90.3%)中获得一件足够的样品，与84.21%的全球敏感，100%的特性和90.32%的全面精确性。复杂并发症率是1.6%。结论：为组织学的检查的足够的胰腺的核心标本能被指导EUS的FNA获得。这种技术为胰腺的瘤的不同类型和良性的疾病的评估的诊断主要是有用的。

简介：Endoscopicultrasonography-guidedfine-needleaspiration（EUS-FNA）hasbeenappliedtopancreaticobiliarylesionssincethe1990sandisinwidespreadusethroughouttheworldtoday.Weusedthismethodtoconfirmthepathologicalevidenceofthepancreaticobiliarylesionsandtoperformsuitabletherapies.ComplicationsofEUS-FNAarequiterare,butsomeofthemaresevere.OperatorsshouldmasterconventionalEUSobservationandexperienceaminimumof20-30casesofsupervisedEUS-FNAonnon-pancreaticandpancreaticlesionsbeforeattemptingsoloEUSFNA.StudiesconductedonpancreaticobiliaryEUSFNAhavefocusedonselectionofsuitableinstruments（e.g.,needleselection）andsamplingtechniques（e.g.,fanningmethod,suctionlevel,withorwithoutastylet,optimumnumberofpasses）.Today,thediagnosticabilityofEUS-FNAisstillimproving;thedetectionofpancreaticcancer（PC）currentlyhasasensitivityof90%-95%andspecificityof95%-100%.InadditiontoPC,avarietyofrarepancreatictumorscanbediscriminatedbyconductingimmunohistochemistryontheFNAmaterials.Aflexible,largecaliberneedlehasbeenusedtoobtainalargepieceoftissue,whichcanprovidesufficienthistologicalinformationtobehelpfulinclassifyingbenignpancreaticlesions.EUSFNAcansupplyhighdiagnosticyieldsevenforbiliarylesionsorperi-pancreaticobiliarylymphnodes.ThisreviewfocusesontheclinicalaspectsofEUS-FNAinthepancreaticobiliaryfield,withtheaimofprovidinginformationthatcanenablemoreaccurateandefficientdiagnosis.