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Endoscopic ultrasound‐through‐the‐needle biopsy in pancreatic cystic lesions: A multicenter study
Author(s) -
Barresi Luca,
Crinò Stefano F.,
Fabbri Carlo,
Attili Fabia,
Poley Jan W.,
Carrara Silvia,
Tarantino Ilaria,
Bernardoni Laura,
Giovanelli Silvia,
Di Leo Milena,
Manfrin Erminia,
Tacelli Matteo,
Bruno Marco J.,
Traina Mario,
Larghi Alberto
Publication year - 2018
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.13197
Subject(s) - medicine , endoscopic ultrasound , multicenter study , radiology , biopsy , ultrasound , general surgery , randomized controlled trial
Background and Aim Tissue acquisition in pancreatic cystic lesions ( PCL ) is the ideal method for diagnosis and risk stratification for malignancy of these lesions. Direct sampling from the walls of PCL with different devices has shown better results than cytology from cystic fluid. We carried out a retrospective, multicenter study to evaluate the feasibility, safety, and diagnostic yield of a micro‐forceps, specifically designed to be used through a 19‐gauge needle after endoscopic ultrasonography ( EUS )‐guided puncture of PCL . Methods We retrospectively collected data from patients who underwent EUS ‐through‐the‐needle biopsy ( EUS ‐ TTNB ) in PCL at six referral centers. Results The sampling procedure was carried out in 56 patients (mean age 57.5 ± 13.1 years, M:F 17:39), and was technically successful in all of them (100%; 95% confidence interval [ CI ], 94–100%). Adverse events occurred in 9/56 (16.1%; 95% CI , 8–28%) patients, with self‐limited intracystic hemorrhage the most common (7/56, 12.5%; 95% CI , 5–24%). All adverse events were mild, and resolved without any specific intervention. Specimens were considered adequate for histological diagnosis in 47/56 (83.9%; 95% CI , 72–92%). In two of these patients, despite the histological adequacy, a diagnosis could not be reached. In two other cases, a specimen sufficient for a cytological diagnosis was obtained. Overall diagnostic yield by combining cytological and histological samples was 47/56 (83.9%; 95% CI , 72–92%). Conclusion EUS ‐ TTNB with micro‐forceps in PCL is feasible, safe, and has a high diagnostic yield. Future prospective studies are needed to better assess the clinical impact of EUS ‐ TTNB on the management of PCL .