Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jun;24(2):175-182.
doi: 10.1007/s40477-020-00542-y. Epub 2021 Feb 1.

Transabdominal ultrasound-guided pancreatic biopsy: a neglected but safe, effective and inexpensive procedure that needs to be re-juvinalized

Fulvia Terracciano  1 , Antonella Marra  2 , Antonio Massimo Ippolito  2 , Fabrizio Bossa  2 , Krizia Sitajolo  3 , Annabianca Amoruso  4 , Paola Parente  5 , Maria Rosa Valvano  2 , Paolo Graziano  5 , Angelo Andriulli  2
Affiliations

Transabdominal ultrasound-guided pancreatic biopsy: a neglected but safe, effective and inexpensive procedure that needs to be re-juvinalized

Fulvia Terracciano et al. J Ultrasound. 2021 Jun.

Abstract

Background: For solid pancreatic masses, ultrasound endoscopic fine-needle biopsy is suggested as the front-line investigation for tissue achievement, notwithstanding the optimal performance of transabdominal ultrasound (TUS)-guided biopsy.

Purpose: To reassess the efficacy and effectiveness of TUS-guided sampling and to determine the factors predictive of accurate histology.

Methods: In total, 142 patients with an indication for a TUS-guided biopsy of a pancreatic mass were analyzed. A single pass of an 18-gauge Biomol needle was carried out by the Menghini technique. The accuracy, sensitivity, and specificity of the procedure in terms of correctly diagnosing an inflammatory or neoplastic lesion were determined. The patients' characteristics, the size and location of the mass, and the sonographers' experience in performing TUS were recorded.

Results: The sampling was unsuccessful in 24 cases, owing to the deep localization of lesions (57%), bloating (33%), or low patient compliance (10%). The accuracy, sensitivity, and specificity of the 118 successful biopsies were 81%, 79%, and 100%, respectively. A biopsy core was obtained in 90 of the 118 patients (76%) in whom the procedure was attempted. In the multivariate analysis, lesion size (≤ 20 mm vs. > 20 mm) (OR = 5.3 [1.7-17.0]) and operator experience (OR = 4.4 [1.6-12.1]) predicted the acquisition of adequate samples. With an expert sonographer, the accuracy, sensitivity, and specificity were 87%, 85%, and 100%, respectively. Two adverse events were registered: mild abdominal pain and a hypotensive crisis.

Conclusions: The present investigation highlights the optimal performance of a TUS-guided biopsy of a pancreatic mass. Because of its simplicity and safety, the procedure needs to be included among the recommended investigative options.

Keywords: Biopsy; Histology; Pancreatic carcinoma; Pancreatic mass; Transabdominal ultrasound.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Ethical statement and informed consent

All subjects gave written informed consent to the treatment of personal data in anonymous form and in accordance with the Declaration of Helsinki.

Figures

Fig. 1
Fig. 1
A flow diagram of the study results
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Polkowski M, Jenssen C, Kaye P et al (2017) Technical aspects of endoscopic ultrasound (EUS)-guided sampling in gastroenterology. European Society for Gastrointestinal Endoscopy (ESGE) Technical Guideline – March 2017. Endoscopy 49:989–1006 - PubMed
    1. Tempero MA, Malafa MP, Al-Hawary M et al (2017) Pancreatic Adenocarcinoma, Version 2.2017. Clinical Practice Guidelines in oncology. J Natl Compr Canc Netw 15:1028–1061 - PubMed
    1. Hewitt MJ, McPhail MJ, Possamai L, et al. EUS-guided FNA for diagnosis of solid pancreatic neoplasms: a meta-analysis. GastrointestEndosc. 2012;75:319–331. - PubMed
    1. Erickson RA, Sayage-Rabie L, Beissner RS, et al. Factors predicting the number of EUS-guided fine-needle passes for diagnosis of pancreatic malignancies. GastrointestEndosc. 2000;51:184–190. - PubMed
    1. Rimbas M, Crino Sf, Gasbarrini A et al (2018) EUS-guided fine-needle tissue acquisition for solid pancreatic lesions: finally moving from fine-needle aspiration to fine-needle biopsy. Endosc Ultrasound 7:137–40 - PMC - PubMed

MeSH terms

LinkOut - more resources