Endoscopic ultrasound-guided tissue sampling: European Society of Gastrointestinal Endoscopy (ESGE) Technical and Technology Review

Antonio Facciorusso; Marianna Arvanitakis; Stefano Francesco Crinò; Carlo Fabbri; Adele Fornelli; John Leeds; Livia Archibugi; Silvia Carrara; Jahnvi Dhar; Paraskevas Gkolfakis; Beate Haugk; Julio Iglesias Garcia; Bertrand Napoleon; Ioannis S. Papanikolaou; Andrada Seicean; Pauline M. C. Stassen; Peter Vilmann; Tony C. Tham; Lorenzo Fuccio

doi:10.1055/a-2524-2596

Endoscopy, Table of Contents

Endoscopy 2025; 57(04): 390-418
DOI: 10.1055/a-2524-2596

Technical Review

Endoscopic ultrasound-guided tissue sampling: European Society of Gastrointestinal Endoscopy (ESGE) Technical and Technology Review

Antonio Facciorusso ‡

¹Department of Experimental Medicine, Section of Gastroenterology, University of Salento, Lecce, Italy (Ringgold ID: RIN18976)

,

Marianna Arvanitakis‡

²Department of Gastroenterology, Digestive Oncology and Hepatopancreatology, HUB Hôpital Erasme, Brussels, Belgium

,

Stefano Francesco Crinò

³Department of Medicine, Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, University Hospital of Verona, Verona, Italy

,

Carlo Fabbri

⁴Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, AUSL Romagna, Forlì-Cesena, Italy (Ringgold ID: RIN390233)

,

Adele Fornelli

⁵Pathology Unit, Ospedale Maggiore „C.A. Pizzardi“, AUSL Bologna, Bologna, Italy

,

John Leeds

⁶Department of Gastroenterology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom (Ringgold ID: RIN5983)

,

Livia Archibugi

⁷Pancreatico-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute, Milan, Italy

,

Silvia Carrara

⁸Department of Biomedical Sciences, Humanitas Pieve Emanuele University, Milan, Italy

⁹IRCCS Humanitas Research Hospital, Milan, Italy (Ringgold ID: RIN9268)

,

Jahnvi Dhar

¹⁰Department of Gastroenterology and Hepatology, Punjab Institute of Liver and Biliary Sciences, Mohali, India

,

Paraskevas Gkolfakis

¹¹Department of Gastroenterology, „Konstantopoulio-Patision“ General Hospital of Nea Ionia, Athens, Greece

,

Beate Haugk

¹²Department of Cellular Pathology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom (Ringgold ID: RIN5983)

,

Julio Iglesias Garcia

¹³Department of Gastroenterology and Hepatology, Health Research Institute of Santiago de Compostela (IDIS), University Hospital of Santiago de Compostela, Santiago, Spain

,

Bertrand Napoleon

¹⁴Department of Gastroenterology, Hôpital privé Jean Mermoz, Lyon, France

,

Ioannis S. Papanikolaou

¹⁵Hepatogastroenterology Unit, Second Department of Propaedeutic Internal Medicine, Medical School, National and Kapodastrian University of Athens, Attikon University General Hospital, Athens, Greece

,

Andrada Seicean

¹⁶Department of Gastroenterology, „Iuliu Haţieganu“ University of Medicine and Pharmacy, Cluj-Napoca, Romania (Ringgold ID: RIN37576)

,

Pauline M. C. Stassen

¹⁷Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands

,

Peter Vilmann

¹⁸Gastroenterology Unit, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark

¹⁹Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark (Ringgold ID: RIN4321)

,

Tony C. Tham

²⁰Division of Gastroenterology, Ulster Hospital, Belfast, Northern Ireland

,

Lorenzo Fuccio

²¹Department of Medical Sciences and Surgery, University of Bologna, Bologna, Italy (Ringgold ID: RIN9296)

› Author Affiliations

Abstract

This Technical and Technology Review from the European Society of Gastrointestinal Endoscopy (ESGE) represents an update of the previous document on the technical aspects of endoscopic ultrasound (EUS)-guided sampling in gastroenterology, including the available types of needle, technical aspects of tissue sampling, new devices, and specimen handling and processing. Among the most important new recommendations are:

ESGE recommends end-cutting fine-needle biopsy (FNB) needles over reverse-bevel FNB or fine-needle aspiration (FNA) needles for tissue sampling of solid pancreatic lesions; FNA may still have a role when rapid on-site evaluation (ROSE) is available.

ESGE recommends EUS-FNB or mucosal incision-assisted biopsy (MIAB) equally for tissue sampling of subepithelial lesions ≥20 mm in size. MIAB could represent the first choice for smaller lesions (<20 mm) if proper expertise is available.

ESGE does not recommend the use of antibiotic prophylaxis before EUS-guided tissue sampling of solid masses and EUS-FNA of pancreatic cystic lesions.

Full Text

References

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Supplementary Material