Endoscopic ultrasound-guided needle-based confocal laser endomicroscopy in pancreatic neoplasms: A single-center experience in China

Objective: The objective of the study is to investigate the application of endoscopic ultrasound-guided needle-based confocal laser endomicroscopy (EUS-nCLE) in the diagnosis of pancreatic neoplasms. Methods: Patients with pancreatic neoplasms were diagnosed by endoscopic ultrasound and punctured by 19G needle; Cellvizio AQ-Flex19 confocal microprobe was implanted through the needle. The diagnostic yield and complication were evaluated and compared with pathology. Results: A total of 28 patients successfully underwent EUS-nCLE examination, including serous cystadenoma (n = 5), mucinous cystadenoma (n = 3), intraductal papillary mucinous neoplasms (n = 3), pseudocyst (n = 1), ductal adenocarcinoma (n = 10), neuroendocrine tumors (1), solid pseudopapillary tumor (n = 2), chronic pancreatitis (n = 2), and lymphoma (n = 1). High-quality images were obtained in all the patients. The diagnostic yield in 26 patients with pathology was 73.1% (19/26) and the specificity of serous cystic neoplasm (SCN) and intraductal papillary mucinous neoplasm (IPMN) was 100% (7/7). The complications, mostly pancreatitis and intracystic hemorrhage, were occurred in 10.7% (3/28) patients. Conclusion: EUS-nCLE is a safe and feasible method in the diagnosis of pancreatic neoplasms and shows high specificity in SCN and IPMN.