Slow-Pull Using a Fanning Technique Is More Useful Than the Standard Suction Technique in EUS-Guided Fine Needle Aspiration in Pancreatic Masses.
- Author:
Jae Min LEE
1
;
Hong Sik LEE
;
Jong Jin HYUN
;
Jung Min LEE
;
In Kyung YOO
;
Seung Han KIM
;
Hyuk Soon CHOI
;
Eun Sun KIM
;
Bora KEUM
;
Yeon Seok SEO
;
Yoon Tae JEEN
;
Hoon Jai CHUN
;
Soon Ho UM
;
Chang Duck KIM
Author Information
- Publication Type:Comparative Study ; Original Article
- Keywords: Pancreas; Endosonography; Biopsy, fine-needle; Technique
- MeSH: Biopsy, Fine-Needle*; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Endosonography; Humans; Male; Needles; Pancreas; Pancreatic Diseases; Prospective Studies; Suction*
- From:Gut and Liver 2018;12(3):360-366
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is useful for obtaining pancreatic mass samples. The combination of modified techniques (i.e., slow-pull technique and fanning technique) may improve the quality of the sample obtained by EUS-FNA. We investigated the effectiveness of a combined slow-pull fanning technique in EUS-FNA for pancreatic mass. METHODS: This prospective comparative study investigated EUS-FNA performed for pancreatic solid masses between August 2015 and July 2016. Pairwise specimens were alternately obtained using the following two techniques for targeted pancreatic lesions: standard suction or slow-pull with fanning. We compared the specimen quality, blood contamination, and diagnostic accuracy of these techniques. RESULTS: Forty-eight consecutive patients were included (29 men; mean age, 68.1±11.9 years), and 96 pancreatic mass specimens were obtained. The slow-pull with fanning technique had a significantly superior diagnostic accuracy than the suction technique (88% vs 71%, p=0.044). Furthermore, blood contamination was significantly reduced using the slow-pull with fanning technique (ratio of no or slight contamination, 77% vs 56%, p=0.041). No difference was observed in the acquisition of adequate cellularity between the groups. In the subgroup analysis, the tumor size and sampling technique were related to the EUS-FNA diagnostic accuracy. CONCLUSIONS: The slow-pull with needle fanning technique showed a good diagnostic yield for EUS-FNA for pancreatic mass. This technique can be useful for performing EUS-guided sampling for diagnosing pancreatic disease.
