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Endoscopic tissue sampling – Part 1: Upper gastrointestinal and hepatopancreatobiliary tracts. European Society of Gastrointestinal Endoscopy (ESGE) Guideline
1 ESGE recommends that, where there is a suspicion of eosinophilic esophagitis, at least six biopsies should be taken, two to four biopsies from the distal esophagus and two to four biopsies from the proximal esophagus, targeting areas with endoscopic mucosal abnormalities. Distal and proximal biopsies should be placed in separate containers.
Strong recommendation, low quality of evidence.
2 ESGE recommends obtaining six biopsies, including from the base and edge of the esophageal ulcers, for histologic analysis in patients with suspected viral esophagitis.
Strong recommendation, low quality of evidence.
3 ESGE recommends at least six biopsies are taken in cases of suspected advanced esophageal cancer and suspected advanced gastric cancer.
Strong recommendation, moderate quality of evidence.
4 ESGE recommends taking only one to two targeted biopsies for lesions in the esophagus or stomach that are potentially amenable to endoscopic resection (Paris classification 0-I, 0-II) in order to confirm the diagnosis and not compromise subsequent endoscopic resection.
Strong recommendation, low quality of evidence.
5 ESGE recommends obtaining two biopsies from the antrum and two from the corpus in patients with suspected Helicobacter pylori infection and for gastritis staging.
Strong recommendation, low quality of evidence.
6 ESGE recommends biopsies from or, if endoscopically resectable, resection of gastric adenomas.
Strong recommendation, moderate quality of evidence.
7 ESGE recommends fine-needle aspiration (FNA) and fine-needle biopsy (FNB) needles equally for sampling of solid pancreatic masses.
Strong recommendation, high quality evidence.
8 ESGE suggests performing peroral cholangioscopy (POC) and/or endoscopic ultrasound (EUS)-guided tissue acquisition in indeterminate biliary strictures. For proximal and intrinsic strictures, POC is preferred. For distal and extrinsic strictures, EUS-guided sampling is preferred, with POC where this is not diagnostic.
Weak recommendation, low quality evidence.
9 ESGE suggests obtaining possible non-neoplastic biopsies before sampling suspected malignant lesions to prevent intraluminal spread of malignant disease.
Weak recommendation, low quality of evidence.
10 ESGE suggests dividing EUS-FNA material into smears (two per pass) and liquid-based cytology (LBC), or the whole of the EUS-FNA material can be processed as LBC, depending on local experience.
Weak recommendation, low quality evidence.
17 September 2021 (online)
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- 1 GRADE Working Group. Grading quality of evidence and strength of recommendations. BMJ 2004; 328: 1490
- 2 Dumonceau JM, Hassan C, Riphaus A. et al. European Society of Gastrointestinal Endoscopy (ESGE) Guideline Development Policy. Endoscopy 2012; 44: 626-629
- 3 Nielsen JA, Lager DJ, Lewin M. et al. The optimal number of biopsy fragments to establish a morphologic diagnosis of eosinophilic esophagitis. Am J Gastroenterol 2014; 109: 515-520
- 4 Shoda T, Wen T, Aceves SS. et al. Eosinophilic oesophagitis endotype classification by molecular, clinical, and histopathological analyses: a cross-sectional study. Lancet Gastroenterol Hepatol 2018; 3: 477-488
- 5 Dellon ES, Speck O, Woodward K. et al. Markers of eosinophilic inflammation for diagnosis of eosinophilic esophagitis and proton pump inhibitor-responsive esophageal eosinophilia: a prospective study. Clin Gastroenterol Hepatol 2014; 12: 2015-2022
- 6 Lucendo AJ, Molina-Infante J, Arias Á. et al. Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults. United European Gastroenterol J 2017; 5: 335-358
- 7 Yantiss RK, Odze RD. Optimal approach to obtaining mucosal biopsies for assessment of inflammatory disorders of the gastrointestinal tract. Am J Gastroenterol 2009; 104: 774-783
- 8 Narayani RI, Burton MP, Young GS. Utility of esophageal biopsy in the diagnosis of nonerosive reflux disease. Dis Esophagus 2003; 16: 187-192
- 9 Schindlbeck NE, Wiebecke B, Klauser AG. et al. Diagnostic value of histology in non-erosive gastro-oesophageal reflux disease. Gut 1996; 39: 151-154
- 10 Pinto D, Plieschnegger W, Schneider NI. et al. Carditis: a relevant marker of gastroesophageal reflux disease. Data from a prospective central European multicenter study on histological and endoscopic diagnosis of esophagitis (histoGERD Trial). Dis Esophagus 2019; DOI: 10.1093/dote/doy073.
- 11 Zhou LY, Wang Y, Lu JJ. et al. Accuracy of diagnosing gastroesophageal reflux disease by GerdQ, esophageal impedance monitoring and histology. J Dig Dis 2014; 15: 230-238
- 12 Zentilin P, Savarino V, Mastracci L. et al. Reassessment of the diagnostic value of histology in patients with GERD, using multiple biopsy sites and an appropriate control group. Am J Gastroenterol 2005; 100: 2299-2306
- 13 Schneider NI, Plieschnegger W, Geppert M. et al. Validation study of the Esohisto consensus guidelines for the recognition of microscopic esophagitis (histoGERD Trial). Hum Pathol 2014; 45: 994-1002
- 14 Gyawali C, Kahrilas PJ, Savarino E. et al. Modern diagnosis of GERD: the Lyon consensus. Gut 2018; 67: 1351-1362
- 15 Madan K, Ahuja V, Gupta SD. et al. Impact of 24-h esophageal pH monitoring on the diagnosis of gastroesophageal reflux disease: defining the gold standard. J Gastroenterol Hepatol 2005; 20: 30-37
- 16 Savarino E, Zentilin P, Mastracci L. et al. Microscopic esophagitis distinguishes patients with non-erosive reflux disease from those with functional heartburn. J Gastroenterol 2013; 48: 473-482
- 17 Antinori A, Antinori A, Ammassari A. et al. Presumptive clinical criteria versus endoscopy in the diagnosis of Candida esophagitis at various HIV-1 disease stages. Endoscopy 1995; 27: 371-376
- 18 Wilcox CM, Alexander LN, Clark WS. et al. Fluconazole compared with endoscopy for human immunodeficiency virus-infected patients with esophageal symptoms. Gastroenterology 1996; 110: 1803-1809
- 19 Redah D, Konutse AY, Agbo K. et al. Is endoscopic diagnosis of Candida albicans esophagitis reliable? Correlations with pathology and mycology. Gastroenterol Clin Biol 2001; 25: 161-163
- 20 Muniraj F, Siddaraju N, Sistla SC. Role of brush cytology in the diagnosis of neoplastic and non-neoplastic upper gastrointestinal lesions. Cytopathology 2016; 27: 407-417
- 21 Geisinger KR. Endoscopic biopsies and cytologic brushings of the esophagus are diagnostically complementary. Am J Clin Pathol 1995; 103: 295-299
- 22 Bonacini M, Young T, Laine L. The causes of esophageal symptoms in human immunodeficiency virus infection. A prospective study of 110 patients. Arch Intern Med 1991; 151: 1567-1572
- 23 Ramanathan J, Rammouni M, Baran J Jr. et al. Herpes simplex virus esophagitis in the immunocompetent host: an overview. Am J Gastroenterol 2000; 95: 2171-2176
- 24 Wilcox CM, Rodgers W, Lazenby A. Prospective comparison of brush cytology, viral culture, and histology for the diagnosis of ulcerative esophagitis in AIDS. Clin Gastroenterol Hepatol 2004; 2: 564-567
- 25 Theise ND, Rotterdam H, Dieterich D. Cytomegalovirus esophagitis in AIDS: diagnosis by endoscopic biopsy. Am J Gastroenterol 1991; 86: 1123-1126
- 26 Wilcox CM, Diehl DL, Cello JP. et al. Cytomegalovirus esophagitis in patients with AIDS. A clinical, endoscopic, and pathologic correlation. Ann Intern Med 1990; 113: 589-593
- 27 Bernard S, Germi R, Lupo J. et al. Symptomatic cytomegalovirus gastrointestinal infection with positive quantitative real-time PCR findings in apparently immunocompetent patients: a case series. Clin Microbiol Infect 2015; 21: 1121
- 28 Wheeler RR, Peacock JE Jr, Cruz JM. et al. Esophagitis in the immunocompromised host: role of esophagoscopy in diagnosis. Rev Infect Dis 1987; 9: 88-96
- 29 Jazeron JF, Barbe C, Frobert E. et al. Virological diagnosis of herpes simplex virus 1 esophagitis by quantitative real-time PCR assay. J Clin Microbiol 2012; 50: 948-952
- 30 McBane RD, Gross JB Jr. Herpes esophagitis: clinical syndrome, endoscopic appearance, and diagnosis in 23 patients. Gastrointest Endosc 1991; 37: 600-603
- 31 Agha FP, Lee HH, Nostrant TT. Herpetic esophagitis: a diagnostic challenge in immunocompromised patients. Am J Gastroenterol 1986; 81: 246-253
- 32 Généreau T, Lortholary O, Bouchaud O. et al. Herpes simplex esophagitis in patients with AIDS: report of 34 cases. The Cooperative Study Group on Herpetic Esophagitis in HIV Infection. Clin Infect Dis 1996; 22: 926-931
- 33 Qumseya B, Saeian K, Massey BT. Endoscopic biopsy for cytomegalovirus in symptomatic immunocompromised patients has low yield in the absence of mucosal lesions. Gastrointest Endosc 2009; 69: AB206
- 34 Canalejo E, García Durán F, Cabello N. et al. Herpes esophagitis in healthy adults and adolescents: report of 3 cases and review of the literature. Medicine (Baltimore) 2010; 89: 204-210
- 35 Mönkemüller KE, Bussian AH, Lazenby AJ. et al. Special histologic stains are rarely beneficial for the evaluation of HIV-related gastrointestinal infections. Am J Clin Pathol 2000; 114: 387-394
- 36 Weusten B, Bisschops R, Coron E. et al. Endoscopic management of Barrett’s esophagus: European Society of Gastrointestinal Endoscopy (ESGE) position statement. Endoscopy 2017; 49: 191-198
- 37 Lal N, Bhasin DK, Malik AK. et al. Optimal number of biopsy specimens in the diagnosis of carcinoma of the oesophagus. Gut 1992; 33: 724-726
- 38 Graham DY, Schwartz JT, Cain GD. et al. Prospective evaluation of biopsy number in the diagnosis of esophageal and gastric carcinoma. Gastroenterology 1982; 82: 228-231
- 39 Nagai K, Ishihara R, Ishiguro S. et al. Endoscopic optical diagnosis provides high diagnostic accuracy of esophageal squamous cell carcinoma. BMC Gastroenterol 2014; 14: 141
- 40 Qizilbash AH, Castelli M, Kowalski MA. et al. Endoscopic brush cytology and biopsy in the diagnosis of cancer of the upper gastrointestinal tract. Acta Cytol 1980; 24: 313-318
- 41 Kaye P, Lindsay D, Madhusudan S. et al. Upper GI biopsies for adenocarcinoma - how many biopsies should endoscopists take?. Histopathology 2019; 74: 959-963
- 42 Malfertheiner P, Megraud F, OʼMorain CA. et al. European Helicobacter and Microbiota Study Group and Consensus panel. Management of Helicobacter pylori infection – the Maastricht V/Florence Consensus Report. Gut 2017; 66: 6-30
- 43 Enomoto H, Watanabe H, Nishikura K. et al. Topographic distribution of Helicobacter pylori in the resected stomach. Eur J Gastroenterol Hepatol 1998; 10: 473-478
- 44 Shi H, Xiong H, Qian W. et al. Helicobacter pylori infection progresses proximally associated with pyloric metaplasia in age-dependent tendency: a cross-sectional study. BMC Gastroenterol 2018; 18: 158
- 45 Sipponen P, Stolte M. Clinical impact of routine biopsies of the gastric antrum and body. Endoscopy 1997; 29: 671-678
- 46 Pimentel-Nunes P, Libânio D, Marcos-Pinto R. et al. Management of epithelial precancerous conditions and lesions in the stomach (MAPS II): European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter and Microbiota Study Group (EHMSG), European Society of Pathology (ESP), and Sociedade Portuguesa de Endoscopia Digestiva (SPED) guideline update 2019. Endoscopy 2019; 51: 365-388
- 47 Castro R, Esposito G, Libânio D. et al. A single vial is enough in the absence of endoscopic suspected intestinal metaplasia – less is more!. Scand J Gastroenterol 2019; 54: 673-677
- 48 Genta R, Schuler C, Robiou C. et al. No association between gastric fundic gland polyps and gastrointestinal neoplasia in a study of over 100,000 patients. Clin Gastroenterol Hepatol 2009; 7: 849-854
- 49 Levy M, Bhattacharya B. Sporadic fundic gland polyps with low-grade dysplasia: a large case series evaluating pathologic and immunohistochemical findings and clinical behavior. Am J Clin Pathol 2015; 144: 592-600
- 50 Jalving M, Koornstra JJ, Götz JM. et al. High-grade dysplasia in sporadic fundic gland polyps: a case report and review of the literature. Eur J Gastroenterol Hepatol 2003; 15: 1229-1233
- 51 Stolte M, Vieth M, Ebert M. High-grade dysplasia in sporadic fundic gland polyps. Eur J Gastroenterol Hepatol 2003; 15: 1153-1156
- 52 Ballecer E, Muddasani R, Forman J. et al. A rare case of high-grade dysplasia in sporadic fundic gland polyps. Am J Gastroenterol 2018; 113: S1463-S1464
- 53 Banks M, Graham D, Jansen M. et al. British Society of Gastroenterology guidelines on the diagnosis and management of patients at risk of gastric adenocarcinoma. Gut 2019; 68: 1545-1575
- 54 Stolte M, Sticht T, Eidt S. et al. Frequency, location, and age and sex distribution of various types of gastric polyp. Endoscopy 1994; 26: 659-665
- 55 Daibo M, Itabashi M, Hirota T. Malignant transformation of gastric hyperplastic polyps. Am J Gastroenterol 1987; 82: 1016-1025
- 56 Abraham S, Yardley J, Wu T. Hyperplastic polyps of the stomach: associations with histologic patterns of gastritis and gastric atrophy. Am J Surg Pathol 2001; 25: 500-507
- 57 Oberhuber G, Stolte M. Gastric polyps: an update of their pathology and biological significance. Virchows Arch 2000; 437: 581-590
- 58 Orlowska J, Jarosz D, Pachlewski J. et al. Malignant transformation of benign epithelial gastric polyps. Am J Gastroenterol 1995; 90: 2152-2159
- 59 Han A, Sung C, Kim K. et al. The clinicopathological features of gastric hyperplastic polyps with neoplastic transformations: a suggestion of indication for endoscopic polypectomy. Gut Liver 2009; 3: 271-275
- 60 Seifert E, Gail K, Weismüller J. Gastric polypectomy. Endoscopy 1983; 15: 8-11
- 61 Forté E, Petit B, Walter T. et al. Risk of neoplastic change in large gastric hyperplastic polyps and recurrence after endoscopic resection. Endoscopy 2020; 52: 444-453
- 62 Lang G, Nalbantoglu I, Early D. et al. High recurrence rate of large hyperplastic polyps after endoscopic resection. Am J Gastroenterol 2016; 111: S499
- 63 Borch K, Skarsgard J, Franzen L. et al. Benign gastric polyps: morphological and functional origin. Dig Dis Sci 2003; 48: 1293
- 64 Cristallini E, Ascani S, Bolis G. Association between histologic type of polyp and carcinoma in the stomach. Gastrointest Endosc 1992; 38: 481-484
- 65 Kamiya T, Morishita T, Asakura H. et al. Long-term follow-up study on gastric adenoma and its relation to gastric protruded carcinoma. Cancer 1982; 50: 2496-2503
- 66 Abraham S, Montgomery E, Singh V. et al. Gastric adenomas. Am J Surg Pathol 2002; 26: 1276-1285
- 67 Laxén F, Sipponen P, Ihamäki T. et al. Gastric polyps; their morphological and endoscopical characteristics and relation to gastric carcinoma. Acta Pathol Microbiol Immunol Scand A 1982; 90: 221-228
- 68 Nishitani M, Yoshida N, Tsuji S. et al. Optimal number of endoscopic biopsies for diagnosis of early gastric cancer. Endosc Int Open 2019; 7: E1683-E1690
- 69 Choi Y, Choi HS, Jeon WK. et al. Optimal number of endoscopic biopsies in diagnosis of advanced gastric and colorectal cancer. J Korean Med Sci 2012; 27: 36-39
- 70 Vivier-Chicoteau J, Lambert J, Coriat R. et al. Development and internal validation of a diagnostic score for gastric linitis plastica. Gastric Cancer 2020; 23: 639-647
- 71 Blair VR, McLeod M, Carneiro F. et al. Hereditary diffuse gastric cancer: updated clinical practice guidelines. Lancet Oncol 2020; 21: e386-e397
- 72 van der Post RS, Vogelaar IP, Carneigo F. et al. Hereditary diffuse gastric cancer: updated clinical guidelines with an emphasis on germline CHD1 mutation carriers. J Med Genet 2015; 52: 361-374
- 73 Ye Y, Tan S. Endoscopic ultrasound-guided fine-needle aspiration biopsy for diagnosis of gastric linitis plastica with negative malignant endoscopy biopsies. Oncol Lett 2018; 16: 4915-4920
- 74 Zhou X, Pan H, Usman A. et al. Endoscopic ultrasound-guided deep and large biopsy for diagnosis of gastric infiltrating tumors with negative malignant endoscopy biopsies. World J Gastroenterol 2015; 21: 3607-3613
- 75 Liu Y, Chen K, Yan X. Endoscopic ultrasound-guided fine-needle aspiration used in diagnosing gastric linitis plastica: Metastatic lymph nodes can be valuable targets. J Gastroenterol Hepatol 2019; 34: 202-206
- 76 Chiyo T, Kobara H, Mori H. et al. Submucosal endoscopic sampling for indefinite gastric linitis plastica infiltrating into the submucosal layer. J Gastrointest Liver Dis 2015; 24: 375-378
- 77 Mooney PD, Kurien M, Evans KE. et al. Clinical and immunologic features of ultra-short celiac disease. Gastroenterol 2016; 150: 1125-1134
- 78 Bai JC, Ciacci C. World Gastroenterology Organisation Global Guidelines, Celiac disease. J Clin Gastroenterol 2017; 51: 755-768
- 79 Rubio-Tapia A, Hill ID, Kelly CP. et al. American College of Gastroenterology clinical guideline: diagnosis and management of celiac disease. Am J Gastroenterol 2013; 108: 656-676
- 80 Robert ME, Crowe SE, Burgart L. et al. Statement on best practices in the use of pathology as a diagnostic tool for celiac disease: a guide for clinicians and pathologists. Am J Surg Pathol 2018; 42: e44-e58
- 81 McCarty TR, O'Brien CR, Gremida A. et al. Efficacy of duodenal bulb biopsy for diagnosis of celiac disease: a systematic review and meta-analysis. Endosc Int Open 2018; 6: E1369-E1378
- 82 Stoven SA, Choung RS, Rubio-Tapia A. et al. Analysis of biopsies from duodenal bulbs of all endoscopy patients increases detection of abnormalities but has a minimal effect on diagnosis of celiac disease. Clin Gastroenterol Hepatol 2016; 14: 1582-1588
- 83 Shamban L, Sorser S, Naydin S. et al. Factors associated with number of duodenal samples obtained in suspected celiac disease. Endosc Int Open 2017; 5: E1220-E1228
- 84 Stavropoulos SN, Im GY, Jlayer Z. et al. High yield of same-session EUS-guided liver biopsy by 19-gauge FNA needle in patients undergoing EUS to exclude biliary obstruction. Gastrointest Endosc 2012; 75: 310-318
- 85 Shuja A, Alkhasawneh A, Fialho A. et al. Comparison of EUS-guided versus percutaneous and transjugular approaches for the performance of liver biopsies. Dig Liver Dis 2019; 51: 826-830
- 86 Diehl D, Johal A, Khara H. et al. Endoscopic ultrasound-guided liver biopsy: a multicenter experience. Endosc Int Open 2015; 3: E210-E215
- 87 Sey MS, Al-Haddad M, Imperiale TF. et al. EUS-guided liver biopsy for parenchymal disease: a comparison of diagnostic yield between two core biopsy needles. Gastrointest Endosc 2016; 83: 347-352
- 88 Pineda JJ, Diehl DL, Miao CL. et al. EUS-guided liver biopsy provides diagnostic samples comparable with those via the percutaneous or transjugular route. Gastrointest Endosc 2016; 83: 360-365
- 89 Shah ND, Sasatomi E, Baron TH. Endoscopic ultrasound-guided parenchymal liver biopsy: single center experience of a new dedicated core needle. Clin Gastroenterol Hepatol 2017; 15: 784-786
- 90 Nieto J, Khaleel H, Challita Y. et al. EUS-guided fine-needle core liver biopsy sampling using a novel 19-gauge needle with modified 1-pass, 1 actuation wet suction technique. Gastrointest Endosc 2018; 87: 469-475
- 91 Rombaoa C, Chen C. The safety and feasibility of endoscopic ultrasound-guided parenchymal liver biopsy at a large community hospital. J Can Assoc Gastroenterol 2018; 1: 282
- 92 Mok SRS, Diehl DL, Johal AS. et al. Endoscopic ultrasound-guided biopsy in chronic liver disease: a randomized comparison of 19-G FNA and 22-G FNB needles. Endosc Int Open 2019; 7: E62-E71
- 93 Bazerbachi F, Vargas EJ, Matar R. et al. EUS-guided core liver biopsy sampling using a 22-gauge fork-tip needle: a prospective blinded trial for histologic and lipidomic evaluation in nonalcoholic fatty liver disease. Gastrointest Endosc 2019; 90: 926-932
- 94 Mohan BP, Shakhatreh M, Garg R. et al. Efficacy and safety of EUS-guided liver biopsy: a systematic review and meta-analysis. Gastrointest Endosc 2019; 89: 238-246
- 95 Hasan MK, Kadkhodayan K, Idrisov E. et al. Endoscopic ultrasound-guided liver biopsy using a 22-G fine needle biopsy needle: a prospective study. Endoscopy 2019; 51: 818-824
- 96 Ching-Companioni RA, Diehl DL, Johal AS. et al. 19 G aspiration needle versus 19 G core biopsy needle for endoscopic ultrasound-guided liver biopsy: a prospective randomized trial. Endoscopy 2019; 51: 1059-1065
- 97 Dumonceau JM, Deprez PH, Jenssen C. et al. Indications, results, and clinical impact of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline–Updated January 2017. Endoscopy 2017; 49: 695-714
- 98 Oppong KW, Bekkali NLH, Leeds JS. et al. Fork-tip needle biopsy versus fine-needle aspiration in endoscopic ultrasound-guided sampling of solid pancreatic masses: a randomized crossover study. Endoscopy 2020; 52: 454-461
- 99 Karsenti D, Palazzo L, Perrot B. et al. 22G Acquire vs. 20G Procore needle for endoscopic ultrasound-guided biopsy of pancreatic masses: a randomized study comparing histologic sample quantity and diagnostic accuracy. Endoscopy 2020; 52: 747-753
- 100 Matsuno J, Ogura T, Kurisu Y. et al. Prospective comparison study of Franseen needle and standard needle use for pancreatic lesions under EUS guidance. Endosc Ultrasound 2019; 8: 412-417
- 101 Ishikawa T, Kawashima H, Ohno E. et al. Clinical impact of EUS-guided fine needle biopsy using a novel Franseen needle for histological assessment of pancreatic diseases. Can J Gastroenterol Hepatol 2019; DOI: 10.1155/2019/8581743.
- 102 Facciorusso A, Bajwa HS, Menon K. et al. Comparison between 22G aspiration and 22G biopsy needles for EUS-guided sampling of pancreatic lesions: A meta-analysis. Endosc Ultrasound 2020; 9: 167-174
- 103 Facciorusso A, Wani S, Triantafyllou K. et al. Comparative accuracy of needle sizes and designs for EUS tissue sampling of solid pancreatic masses: a network meta-analysis. Gastrointest Endosc 2019; 90: 893-903
- 104 Asokkumar R, Yung Ka C, Loh T. et al. Comparison of tissue and molecular yield between fine-needle biopsy (FNB) and fine-needle aspiration (FNA): a randomized study. Endosc Int Open 2019; 7: E955-E963
- 105 van Riet PA, Larghi A, Attili F. et al. A multicenter randomized trial comparing a 25-gauge EUS fine-needle aspiration device with a 20-gauge EUS fine-needle biopsy device. Gastrointest Endosc 2019; 89: 329-339
- 106 Bang JY, Hebert-Magee S, Navaneethan U. et al. EUS-guided fine needle biopsy of pancreatic masses can yield true histology. Gut 2018; 67: 2081-2084
- 107 Hedenström P, Demir A, Khodakaram K. et al. EUS-guided reverse bevel fine-needle biopsy sampling and open tip fine-needle aspiration in solid pancreatic lesions - a prospective, comparative study. Scand J Gastroenterol 2018; 53: 231-237
- 108 Noh DH, Choi K, Gu S. et al. Comparison of 22-gauge standard fine needle versus core biopsy needle for endoscopic ultrasound-guided sampling of suspected pancreatic cancer: a randomized crossover trial. Scand J Gastroenterol 2018; 53: 94-99
- 109 Cheng B, Zhang Y, Chen Q. et al. Analysis of fine-needle biopsy vs fine-needle aspiration in diagnosis of pancreatic and abdominal masses: a prospective, multicenter, randomized controlled trial. Clin Gastroenterol Hepatol 2018; 16: 1314-1321
- 110 Tian L, Tang AL, Zhang L. et al. Evaluation of 22G fine-needle aspiration (FNA) versus fine-needle biopsy (FNB) for endoscopic ultrasound-guided sampling of pancreatic lesions: a prospective comparison study. Surg Endosc 2018; 32: 3533-3539
- 111 Li H, Li W, Zhou QY. et al. Fine needle biopsy is superior to fine needle aspiration in endoscopic ultrasound guided sampling of pancreatic masses: a meta-analysis of randomized controlled trials. Medicine (Baltimore) 2018; 97: e0207
- 112 Wang J, Zhao S, Chen Y. et al. Endoscopic ultrasound guided fine needle aspiration versus endoscopic ultrasound guided fine needle biopsy in sampling pancreatic masses: A meta-analysis. Medicine (Baltimore) 2017; 96: e7452
- 113 Khan MA, Grimm IS, Ali B. et al. A meta-analysis of endoscopic ultrasound-fine-needle aspiration compared to endoscopic ultrasound-fine-needle biopsy: diagnostic yield and the value of onsite cytopathological assessment. Endosc Int Open 2017; 5: E363-E375
- 114 van Riet PA, Erler NS, Bruno MJ. et al. Comparison of fine-needle aspiration and fine-needle biopsy devices for endoscopic ultrasound-guided sampling of solid lesions: a systemic review and meta-analysis. Endoscopy 2021; 53: 411-423
- 115 Tummala P, Munigala S, Eloubeidi MA. et al. Patients with obstructive jaundice and biliary stricture ± mass lesion on imaging: prevalence of malignancy and potential role of EUS-FNA. J Clin Gastroenterol 2013; 47: 532-537
- 116 De Moura DTH, Moura EGH, Bernardo WM. et al. Endoscopic retrograde cholangiopancreatography versus endoscopic ultrasound for tissue diagnosis of malignant biliary stricture: Systematic review and meta-analysis. Endosc Ultrasound 2018; 7: 10-19
- 117 Moura DTH, de Moura EGH, Matuguma SE. et al. EUS-FNA versus ERCP for tissue diagnosis of suspect malignant biliary strictures: a prospective comparative study. Endosc Int Open 2018; 6: E769-E777
- 118 Sadeghi A, Mohamadnejad M, Islami F. et al. Diagnostic yield of EUS-guided FNA for malignant biliary stricture: a systematic review and meta-analysis. Gastrointest Endosc 2016; 83: 290-298
- 119 Sun X, Zhou Z, Tian J. et al. Is single-operator peroral cholangioscopy a useful tool for the diagnosis of indeterminate biliary lesion? A systematic review and meta-analysis. Gastrointest Endosc 2015; 82: 79-87
- 120 Badshah MB, Vanar V, Kandula M. et al. Peroral cholangioscopy with cholangioscopy-directed biopsies in the diagnosis of biliary malignancies: a systemic review and meta-analysis. Eur J Gastroenterol Hepatol 2019; 31: 935-940
- 121 Kulpatcharapong S, Pittayanon R, Kerr SJ. et al. Diagnostic performance of different cholangioscopes in patients with biliary strictures: a systematic review. Endoscopy 2020; 52: 174-185
- 122 Korrapati P, Ciolino J, Wani S. et al. The efficacy of peroral cholangioscopy for difficult bile duct stones and indeterminate strictures: a systematic review and meta-analysis. Endosc Int Open 2016; 4: E263-E275
- 123 de Oliveira PVAG, de Moura DTH, Ribeiro IB. et al. Efficacy of digital single-operator cholangioscopy in the visual interpretation of indeterminate biliary strictures: a systematic review and meta-analysis. Surg Endosc 2020; 34: 3321-3329
- 124 Gerges C, Beyna T, Tang RSY. et al. Digital single-operator peroral cholangioscopy-guided biopsy versus ERCP-guided brushing for indeterminate biliary strictures: a prospective, randomized multicenter trial (with video). Gastrointest Endosc 2020; 91: 1105-1113
- 125 Lee YN, Moon JH, Choi HJ. et al. Tissue acquisition for diagnosis of biliary strictures using peroral cholangioscopy or endoscopic ultrasound-guided fine-needle aspiration. Endoscopy 2019; 51: 50-59
- 126 Barkun A, Liu J, Carpenter S. et al. Update on endoscopic tissue sampling devices. Gastrointest Endosc 2006; 63: 741-745
- 127 Sharaf RN, Shergill AK, Odze RD. et al. Endoscopic mucosal tissue sampling. Gastrointest Endosc 2013; 78: 216-224
- 128 Sussman DA, Deshpande AR, Shankar U. et al. Comparison of performance characteristics of oval cup forceps versus serrated jaw forceps in gastric biopsy. Dig Dis Sci 2016; 61: 2338-2343
- 129 Danesh BJ, Burke M, Newman J. et al. Comparison of weight, depth, and diagnostic adequacy of specimens obtained with 16 different biopsy forceps designed for upper gastrointestinal endoscopy. Gut 1985; 26: 227-231
- 130 Bernstein DE, Barkin JS, Reiner DK. et al. Standard biopsy forceps versus large-capacity forceps with and without needle. Gastrointest Endosc 1995; 41: 573-576
- 131 Woods KL, Anand BS, Cole RA. et al. Influence of endoscopic biopsy forceps characteristics on tissue specimens: results of a prospective randomized study. Gastrointest Endosc 1999; 49: 177-183
- 132 van Riet PA, Quispel R, Cahen DL. et al. Diagnostic yield and agreement on fine-needle specimens from solid pancreatic lesions: comparing the smear technique to liquid-based cytology. Endosc Int Open 2020; 8: E155-E162
- 133 Kopelman Y, Marmor S, Ashkenazi I. et al. Value of EUS-FNA cytological preparations compared with cell block sections in the diagnosis of pancreatic solid tumours. Cytopathology 2011; 22: 174-178
- 134 Hikichi T, Irisawa A, Bhutani MS. et al. Endoscopic ultrasound-guided fine-needle aspiration of solid pancreatic masses with rapid on-site cytological evaluation by endosonographers without attendance of cytopathologists. J Gastroenterol 2009; 44: 322-328
- 135 Nayar MK, Chatterjee S, Wadehra V. et al. Does on-site adequacy assessment by cytotechnologists improve results of EUS guided FNA of solid pancreaticobiliary lesions?. JOP 2013; 14: 44-49
- 136 Alsohaibani F, Girgis S, Sandha GS. Does onsite cytotechnology evaluation improve the accuracy of endoscopic ultrasound-guided fine-needle aspiration biopsy?. Can J Gastroenterol 2009; 23: 26-30
- 137 Ecka RS, Sharma M. Rapid on-site evaluation of EUS-FNA by cytopathologist: an experience of a tertiary hospital. Diagn Cytopathol 2013; 41: 1075-1080
- 138 Da Cunha Santos G, Saieg MA. Preanalytic specimen triage: Smears, cell blocks, cytospin preparations, transport media, and cytobanking. Cancer Cytopathol 2017; 125: 455-464
- 139 Hassan C, Ponchon T, Bisschops R. et al. European Society of Gastrointestinal Endoscopy (ESGE) Publications Policy – Update 2020. Endoscopy 2020; 52: 123-126