Small pancreatic lesions: Is there need for EUS-FNA preoperatively? What to do with the incidental lesions?

Introduction

The advantage of endoscopic ultrasonography (EUS) is its high resolution and capability of local observation [1] [2]. It is one of the most accurate diagnostic methods, particularly for the pancreatobiliary region, where various advanced imaging diagnostic methods available today, such as CT and MRI [3] [4]. Since EUS is most useful for diagnosing a small lesion, its usage for early diagnosis of pancreatobiliary cancer has being anticipated.

Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA) was developed to enhance the diagnostic capability of EUS by providing additional pathological findings [5] [6] [7].

However, it is not clearly known yet whether EUS is actually useful for the diagnosis of small pancreatic tumor, whether EUS-FNA is indispensable when a small tumor is detected. It is also necessary to understand for what size of tumor EUS-FNA can be used, and if there is no risk of complication or not. This time, I introduce the present state of diagnosing small pancreatic tumors, the application of EUS-FNA, and the discussion of the points to be solved.

References

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