Endoscopy 2020; 52(S 01): S139
DOI: 10.1055/s-0040-1704429
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

THE ROLE OF ENDOSCOPIC ULTRASOUND-GUIDED THROUGH-THE-NEEDLE MICROFORCEPS BIOPSY IN THE DIAGNOSIS OF PANCREATIC CYSTIC LESIONS

S Stigliano
1   Campus Bio-Medico, Rome, Italy
2   Sapienza University of Rome, Rome, Italy
,
D Biasutto
1   Campus Bio-Medico, Rome, Italy
,
F Covotta
1   Campus Bio-Medico, Rome, Italy
,
FM Di Matteo
1   Campus Bio-Medico, Rome, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims Pancreatic cystic neoplasms (PCN) are estimated to be present in 2-45% of the general population. Their biological behaviour ranges from benign to malignant disease. Correct management may prevent progression to pancreatic cancer while minimising the need for lifelong screening. Unfortunately, accurate diagnosis and classification of PCN remains a challenge.

To evaluate the safety and technical success of microforceps for EUS-guided through-the-needle biopsy (TTNB) and to assess its diagnostic role in the management of PCN when compared to FNA cyst fluid cytology.

Methods Retrospective study of prospectively enrolled patients who underwent EUS-FNA and TTNB for PCNs with suspicion of malignancy.

The biopsy of cystic wall was obtained using micro-forceps through the 19-gauge needle under EUS visualization. Cystic fluid was collected for cytological analysis.

Technical success was defined as acquisition of a specimen adequate for histological evaluation.

Categorical variables were analysed by means of Fisher’s exact test, and continuous variables by t-test. A p< 0.05 was considered significant.

Results From December 2017 to October 2019, twenty-nine patients were enrolled (21% male; mean age 63±14 years). The mean size of PCNs was 39±16 mm. TTNB was successfully performed in all patients. A diagnostic sample was obtain in 24/29 (82.7%) PCNs with TTNB compared with 13/28 (46.4%) obtained with FNA cyst fluid cytology (p 0.01). Not mucinous PCN were diagnosed in 13/29 patients (44.8%).

Mucinous PCNs were diagnosed in 15/16 (93.7%) with TTNB compared with 8/16 (50%) obtained with FNA cyst fluid cytology (p 0.02).

Complications were observed in 4/29 (13.8%) procedures and were mainly mild acute pancreatitis. Only one patients experienced severe acute pancreatitis with infected fluid collections.

Conclusions EUS-TTNB is effective for evaluating PCNs and it may help increase the diagnostic yield of mucinous PCNs. EUS-TTNB seems to be safe ma not absolutely free from complications so it should be performed in well selected patients.