PT  - JOURNAL ARTICLE
AU  - H M Gordon
AU  - D A J Lloyd
AU  - A Higginson
AU  - R McCrudden
AU  - C Bent
AU  - F W Shek
AU  - R Beable
AU  - A Al-Badri
AU  - B Green
AU  - E Jaynes
AU  - B Foria
AU  - B S F Stacey
TI  - A regional EUS service using a collaborative network
AID  - 10.1136/flgastro-2016-100716
DP  - 2016 Aug 09
TA  - Frontline Gastroenterology
PG  - flgastro-2016-100716
4099  - http://fg.bmj.com/content/early/2016/08/09/flgastro-2016-100716.short
4100  - http://fg.bmj.com/content/early/2016/08/09/flgastro-2016-100716.full
AB  - 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.