Abstract

Background and Aims Several studies have shown the benefits of endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) using a Franseen needle for histological assessment. However, studies focusing on pancreatic diseases are limited and the safety of this method has not been well assessed. We aimed to assess the current status and issues of EUS-FNB in the diagnosis of pancreatic diseases. Materials and Methods We retrospectively reviewed 87 consecutive EUS-FNB specimens using either a 22-gauge Franseen needle (Group A, N = 51) or a conventional 22-gauge fine-needle aspiration needle (Group B, N = 36) for pancreatic diseases, and the diagnostic accuracy and safety were compared. Final diagnoses were obtained based on surgical pathology or a minimum six-month clinical follow-up. Results Although the diagnostic accuracy for malignancy was 96.1% in Group A versus 88.9% in Group B, with no statistically significant difference (P = 0.19), the median sample area was significantly larger in Group A (4.07 versus 1.31mm2, P < 0.0001). There were no differences between the two needles in the locations from which the specimens were obtained. Adverse events occurred in one case (2%) in Group A (mild pancreatitis) and none in Group B with no statistical significance (P = 0.586). Although there was no case of bleeding defined as adverse events, 2 cases in Group A showed active bleeding during the procedure with increase in the echo-free space, which required CT scanning to rule out extravasation. Eventually, the bleeding stopped spontaneously. Conclusions Given its guaranteed ability to obtain core specimens and comparable safety, and although the risk of bleeding should be kept in mind, EUS-FNB using a Franseen needle is likely to become a standard procedure for obtaining pancreatic tissue in the near future.

Highlights

  • In 1998, we first reported the potential for histological diagnosis with endoscopic ultrasound- (EUS-) guided tissue sampling [1]

  • Several studies have already shown the benefits of endoscopic ultrasound-guided fine needle biopsy (EUS-fine needle biopsy (FNB)) using the Franseen needle for histological assessment [3,4,5]; Canadian Journal of Gastroenterology and Hepatology studies focusing on pancreatic diseases are limited

  • We retrospectively reviewed 87 consecutive EUS-FNB specimens obtained from 82 patients using either an Acquire6 22-gauge needle (Boston Scientific Co., Natick, MA, USA) (Group A, N = 51 specimens from 50 patients) or a conventional 22-gauge fine needle aspiration (FNA) needle (EZ shot 3 Plus6, Olympus Co., Ltd., Tokyo, Japan) (Group B, N = 36 specimens from 36 patients) to diagnose pancreatic diseases between October 2016 and March 2018

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Summary

Introduction

In 1998, we first reported the potential for histological diagnosis with endoscopic ultrasound- (EUS-) guided tissue sampling [1]. We assessed the usefulness and safety of this novel Franseen needle compared with a conventional FNA needle and aimed to figure out the current status and issues of EUS-FNB for the histological diagnosis of pancreatic diseases. Several studies have shown the benefits of endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) using a Franseen needle for histological assessment. We retrospectively reviewed 87 consecutive EUS-FNB specimens using either a 22-gauge Franseen needle (Group A, N = 51) or a conventional 22-gauge fine-needle aspiration needle (Group B, N = 36) for pancreatic diseases, and the diagnostic accuracy and safety were compared. Given its guaranteed ability to obtain core specimens and comparable safety, and the risk of bleeding should be kept in mind, EUS-FNB using a Franseen needle is likely to become a standard procedure for obtaining pancreatic tissue in the near future

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