ENDOSCOPIC ULTRASOUND USING A SINGLE TYPE 22 GA NEEDLE FOR PANCREATIC LESIONS WITHOUT ROSE: A SINGLE CENTER, SINGLE OPERATOR RETROSPECTIVE STUDY

Aims Endoscopic ultrasound with fine needle aspiration (EUS with FNA) has proven to be the gold standard in establishing the hystopathological diagnosis for prior hard to reach lesions using conventional methods. The aim of our study is to compare the diagnostic accuracy between the EUS findings and the hystopathological diagnosis using a single type of needle in pancreatic lesions.

Methods We designed a single center, single operator retrospective study between 2016 and 2019 with a total of 259 patients which performed EUS and FNA with a single type of needle (22 Gauge Boston Scientific Expect Needle), without ROSE (rapid on-site evaluation). EUS-FNA was performed using two needle passages and the initial EUS findings were compared with hystopathological results. We divided the patients into two groups: EUS pancreatic benign lesions and EUS pancreatic malignant lesions.

Results From the total of 259 patients EUS with FNA, 194 were included in EUS malignant lesions group (74.9%) and 65 in EUS benign lesions (25.1%). After the hystopathological result we observed that in the initial EUS pancreatic benign lesions group 15 were positive for malignancies (23.08%). While in the EUS pancreatic malignant group 28 were negative for malignancies (14.43%), 7 patients have undergone EUS with FNB of which 5 patients had a confirmation of malignancy.

Conclusions Given the high percentage (23%) of malignancies in the otherwhise EUS pancreatic benign characterized lesions we can conclude that FNA is vital in the use of any type of pancreatic lesion. Two needle passages for EUS pancreatic malignant lesions in the absence of ROSE may prove to be insufficient, therefore more prospective studies are need it fo proper evaluate diferent 22Ga needles types.