Endoscopic ultrasound-through-the-needle biopsy in pancreatic cystic lesions: A large single center experience

查看全文 作　　者：Rintaro [1]Hashimoto;John G [1]Lee;Kenneth J [1]Chang;Nabil El Hage [1]Chehade;Jason B [1]Samarasena

机构地区：[1]H.H.Chao Comprehensive Digestive Disease Center, Division of Gastroenterology and Hepatology, Department of Medicine, University of California,Irvine

出　　处：《World Journal of Gastrointestinal Endoscopy》索引2019年第11卷第11期,共10页

摘　　要：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.EUSTTNB should be considered as an adjunct to EUS-FNA and cytologic analysis in the diagnosis and management of PCLs. 关键词：Pancreatic CYST LESION ENDOSCOPIC ultrasound ENDOSCOPIC ULTRASOUND-GUIDED fine needle ASPIRATION CYST fluid BIOPSY

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Endoscopic ultrasound-through-the-needle biopsy in pancreatic cystic lesions: A large single center experience

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