Impact of biliary stents on EUS-guided FNA of pancreatic mass lesions

Ranney, Nathaniel; Phadnis, Milind A.; Trevino, Jessica; Ramesh, Jayapal; Wilcox, C. Mel; Varadarajulu, Shyam

doi:10.1016/j.gie.2012.02.049

Cited by 36 publications

(48 citation statements)

References 13 publications

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“…This was not proved in our group, perhaps due to the fact that there were only three patients with chronic pancreatitis features. The presence of biliary plastic stents has been reported to diminish the rate of EUS-FNA [30], but it did not influence our results, although biliary stents were seen in about 10% of our cases, as in the other study [30]. As already known from the cytology assessment, the diagnostic accuracy of core biopsy is not related to the mass size or the presence of necrosis inside, facts previously reported also by our group [21,[31][32][33].…”

Section: Discussionsupporting

confidence: 69%

Performance of the Standard 22G Needle for Endoscopic Ultrasound-guided Tissue Core Biopsy in Pancreatic Cancer

Seicean

Gheorghiu

Zaharia

et al. 2016

JGLD

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Background & Aim: Endoscopic ultrasonography (EUS) and EUS-guided fine-needle aspiration (EUS-FNA) are considered good tools for the diagnosis of pancreatic cancer and for obtaining material for cytology or histology. The accuracy of EUS-FNA can rise to 85-95%, but it is lower in cases with a chronic pancreatitis background or with previous biliary stenting. We aimed to establish the diagnostic yield of the visible length of the core biopsy samples in pancreatic cancer by using one single type of standard 22G needle and to evaluate the factors which can influence the results. Method: EUS-FNA was performed by using a 22G standard needle on patients prospectively recruited with the suspicion of pancreatic masses on transabdominal ultrasound or CT scan over a period of eight months. The number of passes was limited by the length of the core obtained. The final diagnosis was based on EUS-FNA or hepatic biopsy for their metastasis or by follow up every three month by imaging methods. Results: The study included 118 patients. Previous stents were present in 10 patients and chronic pancreatitis features were found in 3 patients. The procedure sensitivity was 89% and the global accuracy was 89%. The presence of biliary stents did not impede the accuracy of results. The number of passes did not influence the results. Conclusions: The diagnostic rate of core biopsy by using 22G needles had a high accuracy and it is safe when the length of core dictates the number of passes. The presence of biliary stents did not influence the results. Abbreviations: AUC: area under the curve; EUS: endoscopic ultrasonography; EUS-FNA: fine needle aspiration under endosonographic guidance; FNA: fine needle aspiration; INR: international normalised ratio; OR: odds ratio.

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Section: Discussionsupporting

confidence: 69%

Performance of the Standard 22G Needle for Endoscopic Ultrasound-guided Tissue Core Biopsy in Pancreatic Cancer

Seicean

Gheorghiu

Zaharia

et al. 2016

JGLD

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“…If transpapillary tissue sampling is non‐diagnostic or if early biliary drainage is unnecessary, we recommend EUS‐FNA to secure the pathological diagnosis, especially when the DBS is associated with a mass. Despite concerns that the presence of a biliary stent may compromise the accuracy of EUS imaging, most studies have reported that an indwelling biliary stent does not adversely affect the diagnostic yield of EUS‐FNA . Alternatively, EUS and ERCP may be performed in a single session for evaluation of obstructive jaundice as a result of a pancreatic mass .…”

Section: Methodsmentioning

confidence: 99%

International consensus statements for endoscopic management of distal biliary stricture

Nakai

Isayama

Wang

et al. 2020

J of Gastro and Hepatol

103

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Distal biliary strictures (DBS) are common and may be caused by both malignant and benign pathologies. While endoscopic procedures play a major role in their management, a comprehensive review of the subject is still lacking. Our consensus statements were formulated by a group of expert Asian pancreatico‐biliary interventional endoscopists, following a proposal from the Digestive Endoscopy Society of Taiwan, the Thai Association for Gastrointestinal Endoscopy, and the Tokyo Conference of Asian Pancreato‐biliary Interventional Endoscopy. Based on a literature review utilizing Medline, Cochrane library, and Embase databases, a total of 19 consensus statements on DBS were made on diagnosis, endoscopic drainage, benign biliary stricture, malignant biliary stricture, and management of recurrent biliary obstruction and other complications. Our consensus statements provide comprehensive guidance for the endoscopic management of DBS.

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“…Cytologic diagnosis with EUS‐FNA has been studied extensively, with widely varying sensitivity . The sensitivity has been reported to range from 14% to 100%, whereas specificity has ranged from 69% to 100% .…”

Section: Introductionmentioning

confidence: 99%

False‐negative rate of endoscopic ultrasound‐guided fine‐needle aspiration for pancreatic solid and cystic lesions with matched surgical resections as the gold standard

Woolf

Liang

Sletten

et al. 2013

Cancer Cytopathology

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BACKGROUND:The diagnosis of pancreatic tumors is often complicated because of sampling and interpretive challenges.The current study was performed to determine the rates, types, and causes of diagnostic discrepancies. METHODS: The authors retrospectively reviewed cytology cases from 2004 to 2010 using matched surgical resection cases as the gold standard. RESULTS: A total of 733 cases were divided into 3 categories: 1) positive or suspicious (290 cases); 2) negative or atypical (403 cases); and 3) unsatisfactory (40 cases). Of these cases, 101 fine-needle aspiration (FNA) cases had matched surgical resections including 58 positive diagnoses, 39 negative diagnoses, and 4 unsatisfactory diagnoses. All 19 discrepant cases represented false-negative diagnoses without any false-positive cases noted, which included 2 cases with interpretive errors (10%) and 17 cases with sampling errors (90%). All matched cytology cases were divided into 5 subgroups based on the type of lesion or type of error and were analyzed for sensitivity and specificity. The sampling error rate in cystic lesions (8 of 24; 33%) was significantly higher than that in solid lesions (9 of 73; 12%). The falsenegative rate in the interpretive error group (3%) was significantly lower than that in the sampling error group (23%). CONCLUSIONS:The results of the current study confirm that pancreatic endoscopic ultrasound-guided FNA diagnosis has a very low false-positive rate but a relatively high false-negative rate using matched surgical resections as the gold standard. The major cause of a false-negative cytology diagnosis is sampling error and the rate of sampling error in cystic lesions is significantly higher than that in solid lesions. Cancer (Cancer Cytopathol) 2013;121:449-58. V C 2013 American Cancer Society.KEY WORDS: false-negative; endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of the pancreas; cystic lesion; solid lesion; pancreatic resection.

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Impact of biliary stents on EUS-guided FNA of pancreatic mass lesions

Cited by 36 publications

References 13 publications

Performance of the Standard 22G Needle for Endoscopic Ultrasound-guided Tissue Core Biopsy in Pancreatic Cancer

Performance of the Standard 22G Needle for Endoscopic Ultrasound-guided Tissue Core Biopsy in Pancreatic Cancer

International consensus statements for endoscopic management of distal biliary stricture

False‐negative rate of endoscopic ultrasound‐guided fine‐needle aspiration for pancreatic solid and cystic lesions with matched surgical resections as the gold standard

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