Sa1462 FEASIBILITY, SAFETY, AND DIAGNOSTIC YIELD OF ENDOSCOPIC ULTRASOUND (EUS)-GUIDED FINE NEEDLE CORE BIOPSY FOR NON-FOCAL, BENIGN, PANCREATIC PARENCHYMAL DISEASES

Abstract

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). This pilot study aimed to evaluate the feasibility, safety, and diagnostic yield of EUS-FNB for non-focal, benign, pancreatic parenchymal diseases. This is a retrospective analysis of a prospectively collected database of all patients who underwent EUS-FNB for suspected non-focal, benign, parenchymal pancreatic disease at a single tertiary-care referral center from 10/04/2016 to 10/16/2019. We abstracted and analyzed patient demographics, EUS findings, histopathology, clinical management, and follow-up data. A total of 12 EUS-guided FNB were performed using a 22-gauge needle (83.3% (n=10) with Acquire (Boston Scientific, Natick, MA) needle and 2 with SharkCore (Medtronic Corp., Boston, MA) needle) for suspected non-focal, benign, parenchymal pancreatic disease during the study period. Eleven patients (mean age 39.1±20 years; 54% females) were included in this study. Transgastric (87%) or transduodenal (13%) EUS-FNB was successful in all patients (technical success: 100%). The mean number of FNB passes was 1.7 (median 2, range 1-3) (Figure 1). EUS-FNB provided pancreatic tissue cores that were adequate for histopathological diagnosis in all cases. The mean length of the core biopsy specimen obtained was 12±8.1 mm. Histopathologic diagnoses included: chronic pancreatitis in 4 (36.3%) patients, autoimmune pancreatitis (AIP) in 3 (27.3%), and parenchyma with no diagnostic abnormality in the remaining 4 patients (36.3%). Based on the histopathological diagnosis of AIP, 3 patients were treated with steroid therapy with excellent clinical response. No adverse events such as bleeding, perforation, or post-biopsy pancreatitis were observed during median follow-up of 8 months (range, 1-37; mean 15.6±15.5). EUS-guided FNB using the newer generation 22-gauge biopsy needle is a feasible and safe procedure and provides adequate pancreatic tissue specimen (core biopsy) in all cases for histopathological diagnosis of non-focal, benign, pancreatic parenchymal diseases.