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Education in practice
A regional EUS service using a collaborative network
  1. H M Gordon1,
  2. D A J Lloyd1,
  3. A Higginson2,
  4. R McCrudden3,
  5. C Bent3,
  6. F W Shek4,
  7. R Beable2,
  8. A Al-Badri1,
  9. B Green4,
  10. E Jaynes4,
  11. B Foria3,
  12. B S F Stacey4
  1. 1Department of Gastroenterology, Hampshire Hospitals NHS Foundation Trust, Winchester, UK
  2. 2Portsmouth Hospitals NHS Trust, Portsmouth, UK
  3. 3Royal Bournemouth and Christchurch Foundation Trust, Bournemouth, UK
  4. 4University Hospital Southampton NHS Foundation Trust, Southampton, UK
  1. Correspondence to Dr Harriet Gordon, Consultant Gastroenterologist, The Royal Hampshire County Hospital, Romsey Road, Winchester SO21 3LW, UK; Harriet.Gordon{at}HHFT.nhs.uk

Abstract

Endoscopic ultrasound (EUS) is increasingly used in the management of hepatobiliary lesions, allowing staging and tissue acquisition. It is operator-dependent, and fine needle aspiration (FNA) of solid lesions provides an auditable standard; high-volume centres have shown excellent results for solid pancreatic lesion FNA with sensitivities of 92%–97%. The British Society of Gastroenterology guidelines stress that clinical quality should determine service provision, with geographical accessibility a secondary consideration. We set up the Wessex EUS network, working from a single hepatobiliary (HPB) pancreatic multidisciplinary team, with EUS provided in four local centres providing agreed standards and audit. Pancreatic solid lesion FNA results showed a pooled sensitivity of 94%, comparable with high-volume single centres. This demonstrates a network with good clinical governance is a plausible solution to providing a specialist service such as EUS and may be a roadmap that other specialist services under pressure could follow.

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