Endoscopy 2011; 43 - A100
DOI: 10.1055/s-0031-1292171

Feasibility Study of Forward-viewing and Curved linear-arrayed echoendoscope for pancreato-biliary system; Screening and EUS-FNA

Suzuki Rei 1, Irisawa Atsushi 2, Hikichi Takuto 3, Takagi Tadayuki 1, Tunehiko Ikeda 1, Sato Masaki 1, Watanabe Ko 1, Nakamura Jun 1, Obara Katsutoshi 3, Ohira Hiromasa 1
  • 1Fukushima Medical University School of Medicine, Department of Gastroenterology and Rheumatology, Japan
  • 2Fukushima Medical University, Preparatory office for Aizu Medical Center (Gastroenterology, Japan
  • 3Fukushima Medical University Hospital, Department of Endoscopy

Aim: An oblique-viewing and curved linear-arrayed echoendoscope (OV-ES) is used for not only intervention but also screening of pancreatobiliary system. It has not been investigated whether forward-viewing and curved linear-arrayed echoendoscope (FV-ES) is available for screening of pancreato-biliary system and EUS-FNA for solid pancreatic mass lesions.

Methods: First, we prospectively compared detectability and operability of FV-ES and OV-ES for pancreato-biliary system from August 2009 to January 2010. The detectability was evaluated as follows; 1) observing whole region of pancreas via stomach, 2) observing biliary system from hepatic hilum to ampulla via stomach, 3) and 4) observing pancreatic head and lower bile duct with ampulla via duodenal 1st, and via duodenal 2nd. The operativity was assessed by angulation and torsion of the echoendoscope to detect the check point (celiac trunk/pancreatic body/portal confluence via stomach, bile duct/ampulla and pancreatic head via duodenal 1st). Second, we reviewed the diagnostic yield of EUS-FNA using FV-ES for solid pancreatic lesions comparing that of OV-ES performed during same period as control.

Results: Screening; 42 patients were randomly divided into 2 groups, FV-ES (n=22) and OV-ES (n=20). Regarding detectability, FV-ES could detect pancreato-biliary system as same as OV-ES except for detection of pancreatic head and lower bile duct with ampulla via duodenal 2nd. Regarding operativity, significant difference was not seen in degree of torsion and angulations on each position between FV-ES and OV-ES. EUS-FNA; 36 patients with solid pancreatic mass lesions were performed EUS-FNA. FV-ES was used in 14 patients and OV-ES was used in 22 patients, respectively. There were no significant difference in average age, site of lesions, puncture site and number of passes. Significant difference was not seen in sampling rate, sensitivity, specificity, and accuracy (100% vs. 100%, 100% vs. 100%, 100% vs. 100%, and 100% vs. 100%. P>0.05)

Conclusion: FV-ES was feasibly for screening of pancreato-biliary system. In addition, EUS-FNA with FV-ES had high diagnostic yield in solid pancreatic mass lesions as same as OV-ES.