Endoscopic ultrasound-guided fine needle aspiration for diagnosing pancreatic mass in patients with surgically altered upper gastrointestinal anatomy.
endoscopic ultrasound-guided fine needle aspiration
pancreatic lesion
surgically altered upper gastrointestinal anatomy
Journal
Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society
ISSN: 1443-1661
Titre abrégé: Dig Endosc
Pays: Australia
ID NLM: 9101419
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
13
08
2019
revised:
05
12
2019
accepted:
05
01
2020
pubmed:
9
1
2020
medline:
30
6
2021
entrez:
9
1
2020
Statut:
ppublish
Résumé
Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has been established as a safe and accurate method for diagnosing a pancreatic mass; however, EUS-FNA for patients with surgically altered upper gastrointestinal (UGI) anatomy has not yet been investigated sufficiently. Therefore, the feasibility and safety of EUS-FNA in these patients were retrospectively investigated. Patients in whom EUS-FNA was performed between March 2008 and April 2017 were retrospectively investigated in terms of EUS-FNA technical success, procedure time, diagnostic accuracies of cytology and histology, and procedure-related adverse events. Twenty-five EUS-FNAs were performed for 15 pancreatic body-to-tail and 10 head lesions. All patients underwent EUS-FNA successfully; however, changing of the echoendoscope to a forward-viewing echoendoscope and preplacement of a nasobiliary catheter by balloon-assisted enteroscopy for guidance were needed in one and two cases, respectively. The median procedure time was 26 min (range, 16-70). The diagnostic accuracies were 76%, 84%, and 88% for cytology, histology, and combined use, respectively. Adverse events were not observed. Endoscopic ultrasound-guided FNA is a safe and efficient method for diagnosing a pancreatic mass even in patients with surgically altered UGI anatomy. Nevertheless, some sophisticated techniques are required for pancreatic head lesions if reaching the duodenum after passing through the jejunal limb is required for visualization of the pancreatic mass.
Sections du résumé
BACKGROUND AND AIMS
OBJECTIVE
Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has been established as a safe and accurate method for diagnosing a pancreatic mass; however, EUS-FNA for patients with surgically altered upper gastrointestinal (UGI) anatomy has not yet been investigated sufficiently. Therefore, the feasibility and safety of EUS-FNA in these patients were retrospectively investigated.
METHODS
METHODS
Patients in whom EUS-FNA was performed between March 2008 and April 2017 were retrospectively investigated in terms of EUS-FNA technical success, procedure time, diagnostic accuracies of cytology and histology, and procedure-related adverse events.
RESULTS
RESULTS
Twenty-five EUS-FNAs were performed for 15 pancreatic body-to-tail and 10 head lesions. All patients underwent EUS-FNA successfully; however, changing of the echoendoscope to a forward-viewing echoendoscope and preplacement of a nasobiliary catheter by balloon-assisted enteroscopy for guidance were needed in one and two cases, respectively. The median procedure time was 26 min (range, 16-70). The diagnostic accuracies were 76%, 84%, and 88% for cytology, histology, and combined use, respectively. Adverse events were not observed.
CONCLUSIONS
CONCLUSIONS
Endoscopic ultrasound-guided FNA is a safe and efficient method for diagnosing a pancreatic mass even in patients with surgically altered UGI anatomy. Nevertheless, some sophisticated techniques are required for pancreatic head lesions if reaching the duodenum after passing through the jejunal limb is required for visualization of the pancreatic mass.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
967-973Informations de copyright
© 2020 Japan Gastroenterological Endoscopy Society.
Références
Matsuda T, Marugame T, Kamo K et al. Japan Surveillance Research Group. Cancer incidence and incidence rates in Japan in 2006: Based on data from 15 population based cancer registries in the monitoring of cancer incidence in Japan (MCIJ) project. Jpn. J. Clin. Oncol. 2012; 42: 139-47.
Lai R, Stanley MW, Bardales R et al. Endoscopic ultrasound-guided pancreatic duct aspiration: diagnostic yield and safety. Endoscopy 2002; 34: 715-20.
Varadarajulu S, Tamhane A, Eloubeidi MA. Yield of EUS-guided FNA of pancreatic masses in the presence or the absence of chronic pancreatitis. Gastrointest. Endosc. 2005; 62: 728-36.
Eloubeidi MA, Jhala D, Chhieng DC et al. Yield of endoscopic ultrasound-guided fine-needle aspiration biopsy in patients with suspected pancreatic carcinoma. Cancer 2003; 99: 285-92.
Eloubeidi MA, Chen VK, Eltoum IA et al. Endoscopic ultrasound-guided fine needle aspiration biopsy of patients with suspected pancreatic cancer: Diagnostic accuracy and acute and 30-day complications. Am. J. Gastroenterol. 2003; 98: 2663-8.
Hebert-Magee S, Bae S, Varadarajulu S et al. The presence of a cytopathologist increases the diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration cytology for pancreatic adenocarcinoma: A meta-analysis. Cytopathology 2013; 24: 159-71.
Hewitt MJ, McPhail MJW, Possamai L et al. EUS-guided FNA for diagnosis of solid pancreatic neoplasms: A meta-analysis. Gastrointest. Endosc. 2012; 75: 319-31.
Puli SR, Bechtold ML, Buxbaum JL et al. How good is endoscopic ultrasound-guided fine needle aspiration in diagnosing the correct etiology for a solid pancreatic mass?: A meta-analysis and systematic review. Pancreas 2013; 42: 20-6.
Yamamoto H, Sekine Y, Sato Y et al. Total enteroscopy with a nonsurgical steerable double-balloon method. Gastrointest. Endosc. 2001; 53: 216-20.
Itoi T, Ishii K, Sofuni A et al. Long- and short-type double-balloon enteroscopy-assisted therapeutic ERCP for intact papilla in patients with a Roux-en-Y anastomosis. Surg. Endosc. 2011; 25: 713-21.
Shimatani M, Matsushita M, Takaoka M et al. Effective “short” double-balloon enteroscopy for diagnostic and therapeutic ERCP in patients with altered gastrointestinal anatomy. Endoscopy 2009; 41: 849-54.
Lee JH, Topazian M. Pancreatic endosonography after Bill-roth II gastrectomy. Endoscopy 2004; 36: 972-5.
Wilson JA, Hoffman B, Hawes RH et al. EUS in patients with surgically altered upper GI anatomy. Gastrointest. Endosc. 2010; 72: 574-53.
Pietro F, Marta S, Andrea L et al. Performance of the forward-view echoendoscope for pancreaticobiliary examination in patients with status post-upper gastrointestinal surgery. Endosc. Ultrasound 2015; 4: 336-41.
Yane K, Katanuma A, Maguchi H. Short-type single-balloon enteroscope-assisted ERCP in postsurgical altered anatomy: Potential factors affecting procedural failure. Endoscopy 2017; 49: 69-74.
Bang JY, Magee SH, Ramesh J et al. Randomized trial comparing fanning with standard technique for endoscopic ultrasound-guided fine-needle aspiration of solid pancreatic mass lesions. Endoscopy 2013; 45: 445-50.
Mukai S, Itoi T, Ashida R et al. Multicenter, prospective, crossover trial comparing the door-knocking method with the conventional method for EUS-FNA of solid pancreatic masses. Gastrointest. Endosc. 2016; 83: 1210-7.