Preoperative Histological Diagnosis of Pancreatic Cystic Neoplasms: Is Through the Needle Forceps Sampling the Answer?

Abstract

Accurate preoperative diagnosis of pancreatic cystic lesions (PCLs) is a challenge as image-guided cytology has a very low sensitivity for its diagnosis. The recent advances in endoscopic ultrasound (EUS) such as needle confocal laser endomicroscopy and through the needle biopsy forceps has led to better characterization and diagnosis of the PCL. In this news and views, we discuss a prospective study that has evaluated the efficacy and safety of EUS-guided throughtheneedle biopsy sampling (EUS-TTNB) for diagnosis of PCLs.

Keywords

endosonography - pancreas - cyst - cytology

• References

• 1 Elta GH, Enestvedt BK, Sauer BG, Lennon AM. ACG clinical guideline: diagnosis and management of pancreatic cysts. Am J Gastroenterol 2018; 113 (04) 464-479
• 2 Rana SS, Gupta R. Contrast enhanced EUS for evaluation of mural nodule in pancreatic cystic neoplasm (with video). Endosc Ultrasound 2021; 10 (03) 216-218
• 3 Ge N, Brugge WR, Saxena P. et al. An international, multi-institution survey of the use of EUS in the diagnosis of pancreatic cystic lesions. Endosc Ultrasound 2019; 8 (06) 418-427
• 4 Canakis A, Lee SL. State of the art update of pancreatic cysts. Dis Dig Sci 2021; Aug 12. Doi: 10.1007/s10620-021-07084-1. Epub ahead of print
• 5 Guzmán-Calderón E, Martinez-Moreno B, Casellas JA, de Madaria E, Aparicio JR. Endoscopic ultrasound-guided, through-the-needle forceps biopsy for diagnosis of pancreatic cystic lesions: a systematic review. Endosc Int Open 2020; 8 (09) E1123-E1133
• 6 Cho SH, Song TJ, Seo DW. et al. Efficacy and safety of EUS-guided through-the-needle microforceps biopsy sampling in categorizing the type of pancreatic cystic lesions. Gastrointest Endosc 2022; 95 (02) 299-309
• 7 Crinò SF, Bernardoni L, Brozzi L. et al. Association between macroscopically visible tissue samples and diagnostic accuracy of EUS-guided through-the-needle microforceps biopsy sampling of pancreatic cystic lesions. Gastrointest Endosc 2019; 90 (06) 933-943
• 8 Kovacevic B, Klausen P, Rift CV. et al. Clinical impact of endoscopic ultrasound-guided through-the-needle microbiopsy in patients with pancreatic cysts. Endoscopy 2021; 53 (01) 44-52
• 9 Cheesman AR, Zhu H, Liao X. et al. Impact of EUS-guided microforceps biopsy sampling and needle-based confocal laser endomicroscopy on the diagnostic yield and clinical management of pancreatic cystic lesions. Gastrointest Endosc 2020; 91 (05) 1095-1104