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

Antonio Facciorusso; Marianna Arvanitakis; Stefano Francesco Crinò; Carlo Fabbri; Adele Fornelli; John Leeds; Livia Archibugi; Silvia Carrara; Jahnvi Dhar; Paraskevas Gkolfakis; Beate Haugk; Julio Iglesias Garcia; Bertrand Napoleon; Ioannis S. Papanikolaou; Andrada Seicean; Pauline M. C. Stassen; Peter Vilmann; Tony C. Tham; Lorenzo Fuccio

doi:10.1055/a-2524-2596

Endoscopy, Table of Contents

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

Authors

Antonio Facciorusso ‡

¹Department of Experimental Medicine, Section of Gastroenterology, University of Salento, Lecce, Italy (Ringgold ID: RIN18976)
Marianna Arvanitakis‡

²Department of Gastroenterology, Digestive Oncology and Hepatopancreatology, HUB Hôpital Erasme, Brussels, Belgium
Stefano Francesco Crinò

³Department of Medicine, Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, University Hospital of Verona, Verona, Italy
Carlo Fabbri

⁴Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, AUSL Romagna, Forlì-Cesena, Italy (Ringgold ID: RIN390233)
Adele Fornelli

⁵Pathology Unit, Ospedale Maggiore „C.A. Pizzardi“, AUSL Bologna, Bologna, Italy
John Leeds

⁶Department of Gastroenterology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom (Ringgold ID: RIN5983)
Livia Archibugi

⁷Pancreatico-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
Silvia Carrara

⁸Department of Biomedical Sciences, Humanitas Pieve Emanuele University, Milan, Italy

⁹IRCCS Humanitas Research Hospital, Milan, Italy (Ringgold ID: RIN9268)
Jahnvi Dhar

¹⁰Department of Gastroenterology and Hepatology, Punjab Institute of Liver and Biliary Sciences, Mohali, India
Paraskevas Gkolfakis

¹¹Department of Gastroenterology, „Konstantopoulio-Patision“ General Hospital of Nea Ionia, Athens, Greece
Beate Haugk

¹²Department of Cellular Pathology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom (Ringgold ID: RIN5983)
Julio Iglesias Garcia

¹³Department of Gastroenterology and Hepatology, Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela, Santiago, Spain
Bertrand Napoleon

¹⁴Department of Gastroenterology, Hôpital privé Jean Mermoz, Lyon, France
Ioannis S. Papanikolaou

¹⁵Hepatogastroenterology Unit, Second Department of Propaedeutic Internal Medicine, Medical School, National and Kapodastrian University of Athens, Attikon University General Hospital, Athens, Greece
Andrada Seicean

¹⁶Department of Gastroenterology, „Iuliu Haţieganu“ University of Medicine and Pharmacy, Cluj-Napoca, Romania (Ringgold ID: RIN37576)
Pauline M. C. Stassen

¹⁷Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
Peter Vilmann

¹⁸Gastroenterology Unit, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark

¹⁹Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark (Ringgold ID: RIN4321)
Tony C. Tham

²⁰Division of Gastroenterology, Ulster Hospital, Belfast, Northern Ireland
Lorenzo Fuccio

²¹Department of Medical Sciences and Surgery, University of Bologna, Bologna, Italy (Ringgold ID: RIN9296)

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.

Full Text

References

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