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Endoscopy 2005; 37(4): 362-366
DOI: 10.1055/s-2004-826156
Short Communication
© Georg Thieme Verlag KG Stuttgart · New York

Puncture of Solid Pancreatic Tumors Guided by Endoscopic Ultrasonography: A Pilot Study Series Comparing Trucut and 19-Gauge and 22-Gauge Aspiration Needles

T.  Itoi1 , F.  Itokawa1 , A.  Sofuni1 , K.  Nakamura1 , A.  Tsuchida2 , K.  Yamao3 , T.  Kawai4 , F.  Moriyasu1
  • 1Fourth Department of Internal Medicine, Tokyo Medical University, Tokyo, Japan
  • 2Third Department of Surgery, Tokyo Medical University, Tokyo, Japan
  • 3Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
  • 4Endoscopic Center, Tokyo Medical University, Tokyo, Japan
Further Information

Publication History

Submitted 17 May 2004

Accepted after Revision 21 September 2004

Publication Date:
12 April 2005 (online)

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Background and Study Aims: The aim of this prospective study was to compare endoscopic ultrasonography-guided Trucut needle biopsy (EUS-TNB) with EUS-guided fine-needle aspiration biopsy (EUS-FNAB) using 19- and 22-gauge needles for biopsy from different sites in patients with solid pancreatic cancers.
Patients and Methods: Sixteen consecutive patients with masses in the uncinate process (n = 3), the head (n = 5), or the body and tail (n = 8) of the pancreas underwent both EUS-TNB and EUS-FNAB. The specimens obtained were evaluated by histopathological analysis alone
Results: Tissue specimens were obtained by Trucut needle, and by 19-gauge and 22-gauge aspiration needles in 69 %, 69 %, and 100 % of patients respectively. Sensitivity for malignancy was 69 % for all needles. Tissue sampling by Trucut and by 19-gauge aspiration needle from masses in the uncinate process was impossible. The sensitivity of the Trucut and 19-gauge aspiration needles was 100 % in the 11 patients with successful procedures. If Trucut or19-gauge aspiration needles had been used for body and tail masses, and the 22-gauge aspiration needle for masses in the uncinate process and head, the sensitivity for malignancy would have been 81 %.
Conclusions: EUS-TNB allows reliable tissue sampling for the diagnosis of pancreatic masses, but its use is limited to lesions in the body and tail of the pancreas. EUS-FNAB using a 22-gauge needle may be useful for accurate diagnosis in some patients with masses in the uncinate process or the head of the pancreas.

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T. Itoi, M. D.

Fourth Department of Internal Medicine, Tokyo Medical University

6-7-1 Nishishinjuku · Shinjuku-ku · Tokyo 160-0023 · Japan

Fax: +81-3-5381-6654

Email: itoi@tokyo-med.ac.jp