Reply to the letter of Dr. Gerke

We thank Dr. Gerke for his letter, his contribution, and his continued interest in this area. Indeed, we referred to his paper [1] twice in our own manuscript [2]. It is notable that our two groups independently reported visualization of celiac ganglia during EUS [1] [3] and have now also described a similar frequency of ganglia visualization [1] [2]. We hope that together we will continue to explore and investigate the diagnostic [4] and therapeutic [5] potential of EUS-guided access to celiac ganglia.

Competing interests: None

References

• 1 Gerke H, Silva R G Jr, Shamoun D. et al . EUS characteristics of celiac ganglia with cytologic and histologic confirmation.  Gastrointest Endosc. 2006;  64 35-39
• 2 Gleeson F C, Levy M J, Papachristou G I. et al . Frequency of visualization of presumed celiac ganglia by endoscopic ultrasound.  Endoscopy. 2007;  39 620-624
• 3 Levy M, Rajan E, Keeney G. et al . Neural ganglia visualized by endoscopic ultrasound.  Am J Gastroenterol. 2006;  101 1787-1791
• 4 Levy M J, Topazian M, Keeney G. et al . Preoperative diagnosis of extrapancreatic neural invasion in pancreatic cancer.  Clin Gastroenterol Hepatol. 2006;  4 1479-1482
• 5 Levy M J, Topazian M D, Wiersema M J. et al . Initial evaluation of the efficacy and safety of endoscopic ultrasound-guided direct ganglia neurolysis and block.  Am J Gastroenterol. 2007;  [Epub ahead of print]