Background: An EUS-guided FNA (EUS-FNA) and a therapeutic ERCP are frequently required for the evaluation of patients who were seen for an obstructing periampullary lesion.
Objective: To determine the feasibility and outcomes of combining an EUS-FNA and a therapeutic ERCP into a single session.
Design: Retrospective single-center study.
Setting: Tertiary-referral cancer center.
Patients: A total of 114 patients with a suspected malignant obstructing lesion in the pancreatic head.
Interventions: An EUS with or without FNA plus an ERCP.
Main Outcome Measurements: Duration, diagnostic yield, and complication rate of the combined procedures.
Results: The mean (SD) total procedure time (EUS, with or without FNA plus ERCP) was 73.6 +/- 30 minutes, with a median of 66 minutes (range 25-148 minutes). In many cases, cytologic diagnosis from FNA became available during an ERCP, which obviated the need for further sampling. EUS-FNA had a sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of 84.6%, 100%, 100%, 62.9%, and 87.8%, respectively. During an ERCP, endoscopic sphincterotomies were performed in 51 patients, and biliary stents were placed in 96 patients. Twelve patients (10.5%) had a complication, with 6 having postprocedural pancreatitis.
Limitations: Retrospective single-center experience.
Conclusions: Combined EUS-FNA and therapeutic ERCP is technically feasible, with a complication rate no higher than the component procedures, while efficiently providing tissue diagnosis and biliary drainage.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.gie.2007.11.033 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Adequacy of EUS-guided fine-needle aspiration and fine-needle biopsy for next-generation sequencing in pancreatic malignancies: A systematic review and meta-analysis.
Endosc Ultrasound
December 2024
Department of Gastroenterology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China.
Background And Objectives: A majority of pancreatic malignancies are unresectable at the time of presentation and require EUS-guided fine-needle aspiration or fine-needle biopsy (EUS-FNA/FNB) for diagnosis. With the advent of precision therapy, there is an increasing need to use EUS-FNA/FNB sample for genetic analysis. Next-generation sequencing (NGS) is a preferred technology to detect genetic mutations with high sensitivity in small specimens.
View Article and Find Full Text PDFDiagnostic efficacy of cytologic smear and pathologic histology in the differential diagnosis of distal biliary stricture via EUS-guided fine-needle aspiration.
Endosc Ultrasound
December 2025
Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Disease, Beijing, China.
Background And Objectives: Distal biliary strictures (DBSs) can be caused by various malignancies, making accurate and early diagnosis crucial. Histopathology is the gold standard for diagnosis, with several methods available for tissue sampling. This study evaluates the performance of EUS-guided fine-needle aspiration (EUS-FNA) cytologic smears and histopathology in diagnosing suspected malignant DBSs.
View Article and Find Full Text PDFValue of EUS-guided through-the-needle biopsy in the diagnosis of pancreatic cystic neoplasms: An 8-year experience.
Endosc Ultrasound
December 2024
Department of Gastroenterology, the First Medical Center, Chinese PLA General Hospital, Beijing 100083, China.
Background And Objectives: An accurate diagnosis is crucial for the clinical management of pancreatic cystic neoplasm (PCN). EUS-guided through-the-needle biopsy (EUS-TTNB) is a novel technique for improving the accuracy of PCN diagnosis. There is insufficient evidence about the efficacy of EUS-TTNB.
View Article and Find Full Text PDFEUS-guided fine-needle biopsy fine-needle aspiration for histopathological evidence for type 1 autoimmune pancreatitis: A single-center retrospective study in China.
Endosc Ultrasound
December 2024
Department of Gastroenterology, National Clinical Research Center for Digestive Diseases, Changhai Hospital; and National Key Laboratory of Immunity and Inflammation, Naval Medical University, Shanghai, China.
Background And Objectives: EUS is recommended for guiding pancreatic tissue acquisition in suspected autoimmune pancreatitis (AIP) cases. However, there is a lack of comparative research on the effectiveness between EUS-guided fine-needle aspiration (EUS-FNA) and EUS-guided fine-needle biopsy (EUS-FNB) for diagnosing AIP in China. This study aimed to evaluate the diagnostic accuracy of EUS-guided tissue acquisition (EUS-TA) specifically for type 1 AIP.
View Article and Find Full Text PDFTraction-assisted endoscopic ultrasound-guided fine-needle biopsy using the clip-with-thread method for small gastric subepithelial lesions: Randomized controlled trial (with video).
Dig Endosc
January 2025
Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Objectives: Endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/B) is the gold standard for diagnosing gastric subepithelial lesions (SELs), but diagnosing lesions smaller than 20 mm remains challenging. We developed traction-assisted EUS-FNB (TA-EUS-FNB) using the clip-with-thread method to enhance diagnostic accuracy by stabilizing the lesion and providing counter-traction for easier needle access. This study evaluates the effectiveness of TA-EUS-FNB in diagnosing small gastric SELs.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!