EUS-guided through the needle microbiopsy: a useful adjunct in the investigation of pancreatic cystic lesions.

IF 3.3 Q2 GASTROENTEROLOGY & HEPATOLOGY BMJ Open Gastroenterology Pub Date : 2023-06-01 DOI:10.1136/bmjgast-2023-001184
Wafaa Ahmed, Mikaeil Mirzaali, Caroline Young, Latifu Sanni, Simon Everett, Bharat Paranandi, Matthew T Huggett, Wei On
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Abstract

Objective: Endoscopic ultrasound-guided through-the-needle microbiopsy (EUS-TTNB) forceps is a recent development that facilitates sampling of the walls of pancreatic cystic lesions (PCL) for histological analysis. We aimed to assess the impact of EUS-TTNB and its influence on patient management in a tertiary pancreas centre.

Design: A prospective database of consecutive patients who underwent EUS-TTNB from March 2020 to August 2022 at a tertiary referral centre was retrospectively analysed.

Results: Thirty-four patients (22 women) were identified. Technical success was achieved in all cases. Adequate specimens for histological diagnosis were obtained in 25 (74%) cases. Overall, EUS-TTNB led to a change in management in 24 (71%) cases. Sixteen (47%) patients were downstaged, with 5 (15%) discharged from surveillance. Eight (24%) were upstaged, with 5 (15%) referred for surgical resection. In the 10 (29%) cases without change in management, 7 (21%) had confirmation of diagnosis with no change in surveillance, and 3 (9%) had insufficient biopsies on EUS-TTNB. Two (6%) patients developed post-procedural pancreatitis, and 1 (3%) developed peri-procedural intracystic bleeding with no subsequent clinical sequelae.

Conclusion: EUS-TTNB permits histological confirmation of the nature of PCL, which can alter management outcomes. Care should be taken in patient selection and appropriately consented due to the adverse event rate.

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eus引导下的针显微活检:胰腺囊性病变的一种有用的辅助检查。
目的:超声内镜引导下穿刺显微活检(EUS-TTNB)钳是最近的一项发展,有助于胰腺囊性病变(PCL)壁取样进行组织学分析。我们的目的是评估EUS-TTNB的影响及其对三级胰腺中心患者管理的影响。设计:回顾性分析2020年3月至2022年8月在三级转诊中心连续接受EUS-TTNB患者的前瞻性数据库。结果:34例患者(22例女性)被确诊。在所有情况下都取得了技术上的成功。25例(74%)病例获得足够的组织学诊断标本。总体而言,EUS-TTNB导致24例(71%)病例的管理改变。16例(47%)患者降级,5例(15%)患者退出监测。8例(24%)被抢镜,5例(15%)被转介手术切除。在10例(29%)未改变治疗的病例中,7例(21%)确诊,监测未改变,3例(9%)EUS-TTNB活检不充分。2例(6%)患者出现手术后胰腺炎,1例(3%)患者出现术中囊内出血,无后续临床后遗症。结论:EUS-TTNB允许组织学确认PCL的性质,这可以改变治疗结果。由于不良事件发生率,在患者选择和适当同意时应谨慎。
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来源期刊
BMJ Open Gastroenterology
BMJ Open Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
5.90
自引率
3.20%
发文量
68
审稿时长
2 weeks
期刊介绍: BMJ Open Gastroenterology is an online-only, peer-reviewed, open access gastroenterology journal, dedicated to publishing high-quality medical research from all disciplines and therapeutic areas of gastroenterology. It is the open access companion journal of Gut and is co-owned by the British Society of Gastroenterology. The journal publishes all research study types, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Publishing procedures are built around continuous publication, publishing research online as soon as the article is ready.
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