2802 Endoscopic Ultrasound (EUS)-Guided Needle Biopsy for Benign Pancreatic Diseases

Abstract

INTRODUCTION: Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) is a well-established method for specimen acquisition in suspected pancreatic malignancies. However, the role of EUS-FNA for non-focal, non-neoplastic, benign pancreatic diseases such as chronic pancreatitis and autoimmune pancreatitis is diminished by the sample inadequacy and architectural distortion. This is evaded by histologic core biopsies obtained through newer generation EUS-fine needle biopsy (EUS-FNB). The aim of this study is to evaluate the feasibility, safety, and diagnostic yield of EUS-FNB for benign pancreatic diseases. METHODS: This is a retrospective review of a prospectively collected database of all patients who underwent EUS-FNB for suspected benign parenchymal pancreatic diseases from 02/2017 to 11/2018. The primary objective of this pilot study was to evaluate the feasibility, diagnostic adequacy, and safety of the newer 22-gauge EUS-FNB in the evaluation of benign pancreatic parenchymal diseases. RESULTS: Seven patients (mean age 36.5 ± 18.5 years; 57% males) were included in this study. The mean number of FNB passes was 1.7 (median 2, range 1-3) (Figure 1A and B). Adequate tissue for histopathogical diagnosis was obtained in all cases. Mean length of core biopsy specimen obtained was 12 ± 8.2 mm. Histopathologic diagnoses included: chronic pancreatitis in 2, autoimmune pancreatitis in 2 patients, and parenchyma with no diagnostic abnormality in remaining 3 patients. Two patients with autoimmune pancreatitis were treated with steroid therapy with excellent clinical response. No adverse events such as bleeding, perforation, or post-biopsy pancreatitis were observed on median follow-up of 8.3 (range, 1-21) months. CONCLUSION: EUS-FNB with the newer 22-gauge biopsy needle is a feasible and safe procedure, and provides adequate pancreatic tissue specimen (core biopsy) for histopathological diagnosis of benign pancreatic diseases such as chronic pancreatitis and autoimmune pancreatitis.