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EUS-guided through-the-needle microbiopsy of pancreatic cysts: Technical aspects (with video)


1 Gastroenterology Unit, Division of Endoscopy, Herlev and Gentofte Hospital, Copenhagen University, Herlev, Denmark
2 Gastroenterology Unit, Pancreatitis Centre East, Hvidovre Hospital, Department of Clinical Medicine, Copenhagen University, Hvidovre, Denmark

Correspondence Address:
Bojan Kovacevic,
Herlev Hospital, Borgmester Ib Juuls Vej 1, Herlev 2730
Denmark
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/eus.eus_12_20

PMID: 32611847

Pancreatic cystic lesions are frequently encountered and diagnostically challenging as some of the cysts may have malignant potential (mucinous) while others are completely benign (serous). EUS-guided through-the-needle biopsy (EUS-TTNB) of the cyst wall has recently been introduced as an alternative to cyst fluid cytology. Several studies have shown that microbiopsies outperform cytology in terms of distinction between mucinous and nonmucinous lesions, but also in determining the specific cyst diagnosis. However, little is known about the technical aspects of tissue sampling with TTNB. Herein, we summarize our experience with the procedure in a tertiary referral center and discuss indications, technical aspects, and safety of the procedure. Most adverse events (AEs) associated with the procedure are mild, but there is emerging evidence that the rate of postprocedural pancreatitis is higher compared to standard fine-needle aspiration. The added diagnostic yield should therefore be placed in perspective with an increased risk of AEs. Prospective studies are warranted to fully identify which patient groups could benefit from EUS-TTNB.


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    -  Kovacevic B
    -  Kalaitzakis E
    -  Klausen P
    -  Brink L
    -  Hassan H
    -  Karstensen JG
    -  Vilmann P
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