Journal article
Endoscopic ultrasound-through-the-needle biopsy in pancreatic cystic lesions: A large single center experience
World journal of gastrointestinal endoscopy, Vol.11(11), pp.531-540
11/16/2019
DOI: 10.4253/wjge.v11.i11.531
PMCID: PMC6875688
PMID: 31798774
Abstract
BACKGROUND Establishing a diagnosis of pancreatic cystic lesions (PCLs) preoperatively still remains challenging. Recently, endoscopic ultrasound (EUS)-through-the-needle biopsy (EUS-TTNB) using microforceps in PCLs has been made available. AIM To assess the efficacy and safety of EUS-TTNB in the diagnosis of PCLs. METHODS We retrospectively collected data of patients with PCLs who underwent both EUS-fine-needle aspiration (FNA) for cytology and EUS-TTNB at our institution since 2016. EUS-FNA for cytology was followed by EUS-TTNB in the same session. Evaluation of the cyst location, primary diagnosis, adverse events, and comparison between the cytologic fluid analyses and histopathology was performed. Technical success of EUS-TTNB was defined as visible tissue present after biopsy. Clinical success was defined as the presence of a specimen adequate to make a histologic or cytologic diagnosis. RESULTS A total of 56 patients (mean age 66.9 +/- 11.7, 53.6% females) with PCLs were enrolled over the study period. The mean cyst size was 28.8 mm (12-85 mm). The EUS-TTNB procedure was technically successful in all patients (100%). The clinical success rate using EUS-TTNB was much higher than standard EUS-FNA, respectively 80.4% (45/56) vs 25% (14/56). Adverse events occurred in 2 patients (3.6%) who developed mild pancreatitis that resolved with medical therapy. Using TTNB specimens, 23 of 32 cases (71.9%) with intraductal papillary mucinous neoplasm were further differentiated into gastric type (19 patients) and pancreaticobiliary type (4 patients) based on immunochemical staining. CONCLUSION EUS-TTNB for PCLs was technically feasible and had a favorable safety profile. Furthermore, the diagnostic yield for PCLs was much higher with EUS-TTNB than standard EUS-FNA cytology and fluid carcinoembryonic antigen. EUS-TTNB should be considered as an adjunct to EUS-FNA and cytologic analysis in the diagnosis and management of PCLs.
Details
- Title: Subtitle
- Endoscopic ultrasound-through-the-needle biopsy in pancreatic cystic lesions: A large single center experience
- Creators
- Rintaro Hashimoto - University of California, Irvine Medical CenterJohn G. Lee - University of California, IrvineKenneth J. Chang - University of California, IrvineNabil El Hage Chehade - OrangeJason B. Samarasena - University of California, Irvine
- Resource Type
- Journal article
- Publication Details
- World journal of gastrointestinal endoscopy, Vol.11(11), pp.531-540
- Publisher
- Baishideng Publishing Group Inc
- DOI
- 10.4253/wjge.v11.i11.531
- PMID
- 31798774
- PMCID
- PMC6875688
- ISSN
- 1948-5190
- eISSN
- 1948-5190
- Number of pages
- 11
- Language
- English
- Date published
- 11/16/2019
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984696768302771
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