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DOI: 10.1055/s-0039-1681300
ENDOSCOPIC ULTRASOUND-THROUGH-THE-NEEDLE MICROFORCEPS BIOPSY IN PANCREATIC CYSTIC LESIONS: A SYSTEMATIC REVIEW
Publication History
Publication Date:
18 March 2019 (online)
Aims:
The Moray microforceps biopsy device (MFB) is a disposable tissue acquisition device that can be passed through a 19-gauge needle and it has been recently introduced to facilitate the EUS-guided biopsy of pancreatic cystic lesions (PCL). Our aim was to perform a systematic review of studies evaluating the technical aspects, safety and efficacy of the EUS-guided microforceps biopsy for PCLs.
Methods:
A literature search was performed in three major databases, PubMed, Embase and Web of Science in October, 2018. The search terms used were: “through-the-needle”, “biopsy forceps”, “microforceps”, “endoscopic ultrasound”, and “endosonography”. Case reports and case series with less than 15 patients were excluded from the analysis.
Results:
Altogether 7 retrospective studies reporting on 269 patients were included. Mean age of the patients was 66.3 years, with a slight female predominance (59.5%). The size of the PCLs ranged from 11 to 88 mm and most of them were located in the head or body of the pancreas (69%).
Technical success of EUS-guided MFB was reported in 258/269 cases (96%). Main reasons for technical difficulties were inability to access the cyst while the echoendoscope was fully flexed, difficulty to push the instrument through the needle, and difficulty to visualize the forceps on EUS scan. The tissue acquisition yield reported was 88% (171/194). EUS-guided MFB was able to establish the correct final diagnosis in 151 PCLs out of 212 (diagnostic accuracy, 71%).
Nineteen cases with adverse events (7%) were reported: abdominal pain (1.8%), intracystic hemorrhage (3%), mild acute pancreatitis (1.5%), postprocedural infection (0.7%) and atrial fibrillation after procedure (0.3%).
Conclusions:
EUS-guided MFB is technically feasible, safe and has a high diagnostic accuracy for PCLs. These results should be, however, interpreted with caution. Given the novelty of EUS-guided MFB, further ongoing studies are expected to offer a better understanding of its safety profile and diagnostic accuracy.