EUS-GUIDED FINE-NEEDLE ASPIRATION (EUS-FNA) IN SOLID PANCREATIC LESIONS WITH 2 PASSES IS EQUAL TO 3 PASSES IN COLLECTING ADEQUATE SAMPLE FOR DIAGNOSIS

S Dimitriadis; M Tadic; P Turcic; T Stoos-Veic; K Miltiadou; E Koukoulioti; D Lazaridis; P Gkolfakis; K Triantafyllou; A Vezakis; A Polydorou; I Papanikolaou

doi:10.1055/s-0040-1705024

Endoscopy, Inhaltsverzeichnis

Endoscopy 2020; 52(S 01): S317-S318
DOI: 10.1055/s-0040-1705024

ESGE Days 2020 ePoster presentations

Thursday, April 23, 2020 09:00 – 17:00 Endoscopic ultrasound ePoster area

EUS-GUIDED FINE-NEEDLE ASPIRATION (EUS-FNA) IN SOLID PANCREATIC LESIONS WITH 2 PASSES IS EQUAL TO 3 PASSES IN COLLECTING ADEQUATE SAMPLE FOR DIAGNOSIS

Autor*innen

S Dimitriadis

¹Hepatogastroenterology Unit, 2nd Department of Internal Medicine-Propaedeutic, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece

²Ruhr-Universität Bochum, Universitätsklinikum Knappschaftskrankenhaus Bochum GmbH, Department of Medicine, Bochum, Germany
M Tadic

³Endoscopy Unit, Dept. of Gastroenterology, Hepatology and Clinical Nutrition, Dubrava University Hospital, Zagreb, Croatia
P Turcic

³Endoscopy Unit, Dept. of Gastroenterology, Hepatology and Clinical Nutrition, Dubrava University Hospital, Zagreb, Croatia
T Stoos-Veic

⁴Dubrava University Hospital, Department of Pathology and Cytology, Zagreb, Croatia

⁵Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia
K Miltiadou

¹Hepatogastroenterology Unit, 2nd Department of Internal Medicine-Propaedeutic, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
E Koukoulioti

¹Hepatogastroenterology Unit, 2nd Department of Internal Medicine-Propaedeutic, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
D Lazaridis

¹Hepatogastroenterology Unit, 2nd Department of Internal Medicine-Propaedeutic, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
P Gkolfakis

¹Hepatogastroenterology Unit, 2nd Department of Internal Medicine-Propaedeutic, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
K Triantafyllou

¹Hepatogastroenterology Unit, 2nd Department of Internal Medicine-Propaedeutic, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
A Vezakis

⁶2nd Department of Surgery, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
A Polydorou

⁶2nd Department of Surgery, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
I Papanikolaou

¹Hepatogastroenterology Unit, 2nd Department of Internal Medicine-Propaedeutic, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece

²Ruhr-Universität Bochum, Universitätsklinikum Knappschaftskrankenhaus Bochum GmbH, Department of Medicine, Bochum, Germany

Abstract

Volltext

Aims EUS-FNA has been established as the standard for tissue sampling in solid pancreatic lesions. According to ESGE guidelines three or four needle passes are needed to achieve adequate sampling in >90% of cases in the absence of on-site cytologic evaluation. However, this suggestion is based on low-quality evidence and the ‘perfect’ number of passes is still a matter of discussion. From our historical records, even two passes can suffice for adequate tissue sampling. Thus, the aim of our study was to assess the yield of adequate material when two or three needle passes are performed and to compare these two strategies in terms of incremental tissue yield.

Methods Consecutive patients with solid pancreatic lesions who underwent EUS-FNA in two European tertiary centers between January 2016 and October 2019 were retrospectively included. All EUS-FNAs were performed using 22G or 25G needles; patients were divided into two different groups according to the number of passes (2 vs 3). Patients with more or less passes were excluded. There was no on-site cytologic evaluation. All patients underwent the procedures under propofol sedation.

Results A total of 135 patients were identified, (83=61,5% male). Mean lesion size was 28.4mm (SD 12,3). Of them, 89 lesions (66%) were in the head, followed by 24 (17,8%) in the body. The most common diagnosis was adenocarcinoma (67%).

In 95 patients (70.4%) 2 passes were performed, whereas in 40 patients 3 passes were performed. Adequate tissue sampling was feasible in 86 (90,5 %) and 36 (90%) respectively, with no statistical difference of adequate tissue acquisition between the two groups (p= 0.9).

Conclusions Our study suggests that even two EUS-FNA passes in solid pancreatic lesions can provide sufficient tissue to facilitate a diagnosis, with no significant incremental tissue yield if three passes are performed.