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Background Endosonography (EUS) evolved from purely diagnostic imaging modality to be a method that allows tissue acquisition and therapeutic intervention. EUS-guided fine needle aspiration (EUS-FNA) permits cytological confirmation of imaging findings and is performed with high sensitivity and specificity in addition to low incidence of adverse events. Standard EUS-FNA involve use of either no-suction or suction techniques. New sampling technique; capillary (stylet slow-pull) technique, involves slow withdrawal of the stylet creating a small negative pressure. Aim of the work The aim of this study is to compare the quality of samples acquired by capillary technique versus suction technique using 22-gauge needles. Patients and methods Patients referred for EUS-FNA for upper gastrointestinal lesions (pancreatic or luminal) were included in the study. Each lesion was sampled twice, the first was taken using suction technique (applying negative pressure suction using standard 10 ml syringe) while the second one by capillary (stylet slow-pull) technique. After sample processing and staining, cytopathologist reviewed the material blinded to the technique used. The quality of samples was assessed regarding 3 aspects; cellularity, sample contamination by blood or mucosal cells. Results A total of 51 patients (37/14 males/females, mean age 55.4) referred for EUSFNA were included. Cytological diagnosis was: pancreatic adenocarcinoma in 38/51 (74.51%), Gastrointestinal stromal tumor in 4/51 (7.84%), inconclusive result in 3/51 (5.88%), the rest were solid pseudopapillary neoplasm, Serous cystic neoplasm, Mucinous cystic neoplasm, inflammatory lesions (papillitis, pancreatitis) and metastatic lesion 1 patient for each (1.96%). The sample cellularity score showed no statistically significant difference between both sampling techniques (P = 0.18). Blood contamination score was significantly lower in the capillary technique (P &amp;lt; 0.0001) indicating more blood contamination in suction technique samples. Conclusion Both techniques provided comparable diagnostic performance. However, capillary technique showed less sample contamination by blood cells resulting in a slightly better-quality sample.

Accuracy of Endoscopic Ultrasound Guided Fine Needle Aspiration In Sampling Of Pancreatic & Gastrointestinal Lesions Using Capillary Versus Suction Technique