TY - JOUR

T1 - EUS-guided through-the-needle microbiopsy of pancreatic cysts

T2 - Technical aspects (with video)

AU - Kovacevic, Bojan

AU - Kalaitzakis, Evangelos

AU - Klausen, Pia

AU - Brink, Lene

AU - Hassan, Hazem

AU - Karstensen, John

AU - Vilmann, Peter

PY - 2020

Y1 - 2020

N2 - Pancreatic cystic lesions are frequently encountered and diagnostically challenging as some of the cysts may have malignant potential (mucinous) while others are completely benign (serous). EUS-guided through-the-needle biopsy (EUS-TTNB) of the cyst wall has recently been introduced as an alternative to cyst fluid cytology. Several studies have shown that microbiopsies outperform cytology in terms of distinction between mucinous and nonmucinous lesions, but also in determining the specific cyst diagnosis. However, little is known about the technical aspects of tissue sampling with TTNB. Herein, we summarize our experience with the procedure in a tertiary referral center and discuss indications, technical aspects, and safety of the procedure. Most adverse events (AEs) associated with the procedure are mild, but there is emerging evidence that the rate of postprocedural pancreatitis is higher compared to standard fine-needle aspiration. The added diagnostic yield should therefore be placed in perspective with an increased risk of AEs. Prospective studies are warranted to fully identify which patient groups could benefit from EUS-TTNB.

AB - Pancreatic cystic lesions are frequently encountered and diagnostically challenging as some of the cysts may have malignant potential (mucinous) while others are completely benign (serous). EUS-guided through-the-needle biopsy (EUS-TTNB) of the cyst wall has recently been introduced as an alternative to cyst fluid cytology. Several studies have shown that microbiopsies outperform cytology in terms of distinction between mucinous and nonmucinous lesions, but also in determining the specific cyst diagnosis. However, little is known about the technical aspects of tissue sampling with TTNB. Herein, we summarize our experience with the procedure in a tertiary referral center and discuss indications, technical aspects, and safety of the procedure. Most adverse events (AEs) associated with the procedure are mild, but there is emerging evidence that the rate of postprocedural pancreatitis is higher compared to standard fine-needle aspiration. The added diagnostic yield should therefore be placed in perspective with an increased risk of AEs. Prospective studies are warranted to fully identify which patient groups could benefit from EUS-TTNB.

KW - EUS

KW - intraductal papillary mucinous neoplasm

KW - microbiopsy

KW - pancreatic cyst

KW - pancreatic cystic lesion

KW - through-the-needle biopsy

U2 - 10.4103/eus.eus_12_20

DO - 10.4103/eus.eus_12_20

M3 - Review

C2 - 32611847

AN - SCOPUS:85090913326

VL - 9

SP - 220

EP - 224

JO - Endoscopic Ultrasound

JF - Endoscopic Ultrasound

SN - 2226-7190

IS - 4

ER -