Endoscopic ultrasound-through-the-needle biopsy in pancreatic cystic lesions: A multicenter study

Luca Barresi, Stefano F. Crinò, Carlo Fabbri, Fabia Attili, Jan W. Poley, Silvia Carrara, Ilaria Tarantino, Laura Bernardoni, Silvia Giovanelli, Milena Di Leo, Erminia Manfrin, Matteo Tacelli, Marco J. Bruno, Mario Traina, Alberto Larghi

Research output: Contribution to journalArticle

Abstract

Background and Aim: Tissue acquisition in pancreatic cystic lesions (PCL) is the ideal method for diagnosis and risk stratification for malignancy of these lesions. Direct sampling from the walls of PCL with different devices has shown better results than cytology from cystic fluid. We carried out a retrospective, multicenter study to evaluate the feasibility, safety, and diagnostic yield of a micro-forceps, specifically designed to be used through a 19-gauge needle after endoscopic ultrasonography (EUS)-guided puncture of PCL. Methods: We retrospectively collected data from patients who underwent EUS-through-the-needle biopsy (EUS-TTNB) in PCL at six referral centers. Results: The sampling procedure was carried out in 56 patients (mean age 57.5 ± 13.1 years, M:F 17:39), and was technically successful in all of them (100%; 95% confidence interval [CI], 94–100%). Adverse events occurred in 9/56 (16.1%; 95% CI, 8–28%) patients, with self-limited intracystic hemorrhage the most common (7/56, 12.5%; 95% CI, 5–24%). All adverse events were mild, and resolved without any specific intervention. Specimens were considered adequate for histological diagnosis in 47/56 (83.9%; 95% CI, 72–92%). In two of these patients, despite the histological adequacy, a diagnosis could not be reached. In two other cases, a specimen sufficient for a cytological diagnosis was obtained. Overall diagnostic yield by combining cytological and histological samples was 47/56 (83.9%; 95% CI, 72–92%). Conclusion: EUS-TTNB with micro-forceps in PCL is feasible, safe, and has a high diagnostic yield. Future prospective studies are needed to better assess the clinical impact of EUS-TTNB on the management of PCL.

Original languageEnglish
Pages (from-to)760-770
Number of pages11
JournalDigestive Endoscopy
Volume30
Issue number6
DOIs
Publication statusPublished - Nov 1 2018

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Needle Biopsy
Endosonography
Multicenter Studies
Confidence Intervals
Surgical Instruments
Punctures
Needles
Cell Biology
Referral and Consultation
Retrospective Studies
Prospective Studies
Hemorrhage
Safety
Equipment and Supplies
Neoplasms

Keywords

  • endoscopic ultrasound
  • pancreatic cystic lesion
  • pancreatic disease
  • tissue acquisition in pancreatic cystic lesion

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Endoscopic ultrasound-through-the-needle biopsy in pancreatic cystic lesions : A multicenter study. / Barresi, Luca; Crinò, Stefano F.; Fabbri, Carlo; Attili, Fabia; Poley, Jan W.; Carrara, Silvia; Tarantino, Ilaria; Bernardoni, Laura; Giovanelli, Silvia; Di Leo, Milena; Manfrin, Erminia; Tacelli, Matteo; Bruno, Marco J.; Traina, Mario; Larghi, Alberto.

In: Digestive Endoscopy, Vol. 30, No. 6, 01.11.2018, p. 760-770.

Research output: Contribution to journalArticle

Barresi, L, Crinò, SF, Fabbri, C, Attili, F, Poley, JW, Carrara, S, Tarantino, I, Bernardoni, L, Giovanelli, S, Di Leo, M, Manfrin, E, Tacelli, M, Bruno, MJ, Traina, M & Larghi, A 2018, 'Endoscopic ultrasound-through-the-needle biopsy in pancreatic cystic lesions: A multicenter study', Digestive Endoscopy, vol. 30, no. 6, pp. 760-770. https://doi.org/10.1111/den.13197
Barresi, Luca ; Crinò, Stefano F. ; Fabbri, Carlo ; Attili, Fabia ; Poley, Jan W. ; Carrara, Silvia ; Tarantino, Ilaria ; Bernardoni, Laura ; Giovanelli, Silvia ; Di Leo, Milena ; Manfrin, Erminia ; Tacelli, Matteo ; Bruno, Marco J. ; Traina, Mario ; Larghi, Alberto. / Endoscopic ultrasound-through-the-needle biopsy in pancreatic cystic lesions : A multicenter study. In: Digestive Endoscopy. 2018 ; Vol. 30, No. 6. pp. 760-770.
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AU - Barresi, Luca

AU - Crinò, Stefano F.

AU - Fabbri, Carlo

AU - Attili, Fabia

AU - Poley, Jan W.

AU - Carrara, Silvia

AU - Tarantino, Ilaria

AU - Bernardoni, Laura

AU - Giovanelli, Silvia

AU - Di Leo, Milena

AU - Manfrin, Erminia

AU - Tacelli, Matteo

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AU - Larghi, Alberto

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