Prospective evaluation of slow-pull with fanning technique in EUS-guided fine needle aspiration on pancreatic masses.

Abstract

232 Background: Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) is useful in obtaining pancreatic mass samples. Combination of modified techniques (slow-pull technique and fanning technique) may improve the sample quality obtained by EUS-FNA. We investigated the effectiveness of a slow-pull with fanning technique in EUS-FNA for pancreatic mass. Methods: This prospective comparative study investigated EUS-FNA for pancreatic solid masses from August 2015-July 2016. The pairwise specimens were alternately obtained using two techniques: standard suction or slow-pull with fanning for target pancreatic lesions. We compared the specimen quality, blood contamination, and diagnostic yield of these techniques. Results: Forty-eight consecutive patients were enrolled (29 men; mean age, 68.1±11.9 years), and 96 pancreatic mass specimens were obtained. The slow-pull with fanning technique had significantly superior diagnostic accuracy than the suction technique (88% vs. 71%, p = 0.044). Further, blood contamination significantly reduced when the slow-pull with fanning technique was used (ratio of no or few contamination, 77% vs. 56%, p = 0.041). In the subgroup analysis, tumor size and sampling technique were related to EUS-FNA diagnostic accuracy. Conclusions: The slow-pull with needle fanning technique showed a good diagnostic yield for EUS-FNA for pancreatic mass. It can be useful in performing EUS-guided sampling for diagnosing pancreatic disease.