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Endoscopy 2025; 57(04): 390-418
DOI: 10.1055/a-2524-2596
Technical Review

Endoscopic ultrasound-guided tissue sampling: European Society of Gastrointestinal Endoscopy (ESGE) Technical and Technology Review

Antonio Facciorusso  ‡
1   Department of Experimental Medicine, Section of Gastroenterology, University of Salento, Lecce, Italy (Ringgold ID: RIN18976)
,
Marianna Arvanitakis‡
2   Department of Gastroenterology, Digestive Oncology and Hepatopancreatology, HUB Hôpital Erasme, Brussels, Belgium
,
Stefano Francesco Crinò
3   Department of Medicine, Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, University Hospital of Verona, Verona, Italy
,
Carlo Fabbri
4   Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, AUSL Romagna, Forlì-Cesena, Italy (Ringgold ID: RIN390233)
,
Adele Fornelli
5   Pathology Unit, Ospedale Maggiore „C.A. Pizzardi“, AUSL Bologna, Bologna, Italy
,
John Leeds 
6   Department of Gastroenterology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom (Ringgold ID: RIN5983)
,
Livia Archibugi
7   Pancreatico-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
,
Silvia Carrara
8   Department of Biomedical Sciences, Humanitas Pieve Emanuele University, Milan, Italy
9   IRCCS Humanitas Research Hospital, Milan, Italy (Ringgold ID: RIN9268)
,
Jahnvi Dhar
10   Department of Gastroenterology and Hepatology, Punjab Institute of Liver and Biliary Sciences, Mohali, India
,
Paraskevas Gkolfakis
11   Department of Gastroenterology, „Konstantopoulio-Patision“ General Hospital of Nea Ionia, Athens, Greece
,
Beate Haugk
12   Department of Cellular Pathology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom (Ringgold ID: RIN5983)
,
Julio Iglesias Garcia
13   Department of Gastroenterology and Hepatology, Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela, Santiago, Spain
,
Bertrand Napoleon 
14   Department of Gastroenterology, Hôpital privé Jean Mermoz, Lyon, France
,
Ioannis S. Papanikolaou
15   Hepatogastroenterology Unit, Second Department of Propaedeutic Internal Medicine, Medical School, National and Kapodastrian University of Athens, Attikon University General Hospital, Athens, Greece
,
Andrada Seicean
16   Department of Gastroenterology, „Iuliu Haţieganu“ University of Medicine and Pharmacy, Cluj-Napoca, Romania (Ringgold ID: RIN37576)
,
Pauline M. C. Stassen 
17   Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
,
Peter Vilmann
18   Gastroenterology Unit, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark
19   Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark (Ringgold ID: RIN4321)
,
Tony C. Tham 
20   Division of Gastroenterology, Ulster Hospital, Belfast, Northern Ireland
,
Lorenzo Fuccio 
21   Department of Medical Sciences and Surgery, University of Bologna, Bologna, Italy (Ringgold ID: RIN9296)
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Abstract

This Technical and Technology Review from the European Society of Gastrointestinal Endoscopy (ESGE) represents an update of the previous document on the technical aspects of endoscopic ultrasound (EUS)-guided sampling in gastroenterology, including the available types of needle, technical aspects of tissue sampling, new devices, and specimen handling and processing. Among the most important new recommendations are:

ESGE recommends end-cutting fine-needle biopsy (FNB) needles over reverse-bevel FNB or fine-needle aspiration (FNA) needles for tissue sampling of solid pancreatic lesions; FNA may still have a role when rapid on-site evaluation (ROSE) is available.

ESGE recommends EUS-FNB or mucosal incision-assisted biopsy (MIAB) equally for tissue sampling of subepithelial lesions ≥20 mm in size. MIAB could represent the first choice for smaller lesions (<20 mm) if proper expertise is available.

ESGE does not recommend the use of antibiotic prophylaxis before EUS-guided tissue sampling of solid masses and EUS-FNA of pancreatic cystic lesions.

Supplementary Material



Publication History

Article published online:
27 February 2025

© 2025. European Society of Gastrointestinal Endoscopy. All rights reserved..

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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