Endoscopy 2020; 52(S 01): S138-S139
DOI: 10.1055/s-0040-1704428
ESGE Days 2020 ePoster Podium presentations
Pancreatic cysts 11:00 – 11:30 Thursday, April 23, 2020 ePoster Podium 3
© Georg Thieme Verlag KG Stuttgart · New York

CLINICAL IMPACT AND SAFETY OF ENDOSCOPIC ULTRASOUND-GUIDED THROUGH THE NEEDLE MICROBIOPSIES IN PATIENTS WITH PANCREATIC CYSTS - A PROSPECTIVE SINGLE CENTER STUDY

B Kovacevic
1   Herlev Hospital, Copenhagen University, Gastro Unit, Division of Endoscopy, Herlev, Denmark
,
P Klausen
1   Herlev Hospital, Copenhagen University, Gastro Unit, Division of Endoscopy, Herlev, Denmark
,
CV Rift
2   RigshospitaletCopenhagen University, Department of Pathology, Copenhagen, Denmark
,
A Toxværd
3   Copenhagen University, Department of Pathology, Herlev, Denmark
,
H Grossjohann
4   Rigshospitalet, Copenhagen University, Department of Gastrointestinal Surgery, Copenhagen, Denmark
,
JG Karstensen
5   Hvidovre Hospital, Copenhagen University, Gastro Unit, Pancreatitis Centre East, Herlev, Denmark
,
L Brink
1   Herlev Hospital, Copenhagen University, Gastro Unit, Division of Endoscopy, Herlev, Denmark
,
HH Al-Hashemi
1   Herlev Hospital, Copenhagen University, Gastro Unit, Division of Endoscopy, Herlev, Denmark
,
E Kalaitzakis
1   Herlev Hospital, Copenhagen University, Gastro Unit, Division of Endoscopy, Herlev, Denmark
,
J Storkholm
4   Rigshospitalet, Copenhagen University, Department of Gastrointestinal Surgery, Copenhagen, Denmark
,
CP Hansen
4   Rigshospitalet, Copenhagen University, Department of Gastrointestinal Surgery, Copenhagen, Denmark
,
JP Hasselby
2   RigshospitaletCopenhagen University, Department of Pathology, Copenhagen, Denmark
,
P Vilmann
1   Herlev Hospital, Copenhagen University, Gastro Unit, Division of Endoscopy, Herlev, Denmark
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

Also available at
 

Aims Previously, results of EUS-guided through-the-needle biopsies (TTNBs) from pancreatic cystic lesions have been reported in several, mainly retrospective studies. While the technique is associated with high technical success and diagnostic yield, there is a lack of evidence concerning its added diagnostic value.

Methods Primary aim of this prospective single-center study was to estimate the clinical impact of TTNBs. Between February 2018 and August 2019, we included consecutive patients presenting with a pancreatic cystic lesion of 15 mm or above referred for EUS examination. Secondary outcomes included technical success, diagnostic yield, interrater reliability for TTNB, and adverse event (AE) rate. AEs were defined according to current ASGE lexicon.

Results One hundred and one patients were included. Technical success was high (n=95, 94.1%). Diagnostic yield of TTNB was higher compared to FNA-cytology, 70.3% and 31.7% (p < 0.001), respectively. Additional diagnostic yield of TTNB, leading to change in clinical management, was 11.9%. Of these, a diagnosis of SCN was made in ten cases, leading to discontinuation of follow-up. In the remaining two cases, a diagnosis of MCN and IPMN was made in spite of low CEA concentration in cyst fluid. Interrater reliability was substantial to almost perfect for all measured parameters. AE rate was 9.9% (four mild, three moderate, two severe and one fatal) and did not change significantly following introduction of aggressive perioperative hydration with Ringer lactate and rectal NSAIDs (17.6% vs. 8.3%, p=0.366). Most common AE was pancreatitis, three of which severe.

Conclusions TTNBs had an additional diagnostic yield of 11.9% compared to FNA-cytology and cross-sectional imaging, resulting in important change of clinical management. However, the procedure seems to be associated with severe adverse events and a substantial overall adverse event rate. Further studies will elucidate the appropriate indications of TTNB and in which subgroup of patients the clinical implication will outweigh the risk.