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EUS-through-the-needle microbiopsy forceps in pancreatic cystic lesions: A systematic review
Vasile Daniel Balaban1, Irina M Cazacu2, Larisa Pinte3
1Internal Medicine and Gastroenterology Clinic, "Carol Davila" University of Medicine and Pharmacy, Craiova; Department of Gastroenterology, "Dr. Carol Davila" Central Military Emergency University Hospital, Bucharest, Romania.
Abstract:
Pancreatic cystic lesions (PCLs) are being increasingly encountered in clinical practice, and sometimes, they can represent a diagnostic challenge. Recently, a through-the-needle micro forceps biopsy (MFB) device was introduced in the endosonography practice to facilitate EUS-guided sampling of PCLs. The aim was to perform a systematic review of studies evaluating the technical aspects, safety, and efficacy of the EUS-guided MFB for PCLs. A literature search was performed in three major databases, PubMed, Embase, and Web of Science in September 2019 using the search terms: "through-the-needle," "biopsy forceps," "microforceps," "endoscopic ultrasound," and "endosonography." Case reports and case series with <10 patients were excluded from the analysis. Altogether nine studies reporting on 463 patients were included in our systematic review. The mean age of the patients was 68.3 years, with a slight female predominance (60.9%). Most of the cysts were located in the body/tail of the pancreas (61.2%), with an overall mean size of 33 mm. The technical success of EUS-guided MFB was reported in 98.5%. The tissue acquisition yield reported was 88.2%, and the diagnostic accuracy was 68.6%. Adverse events were reported in 9.7%. EUS-guided MFB is technically feasible, safe, and has a high diagnostic accuracy for PCLs.
Insights
Endoscopic ultrasound-guided micro forceps biopsy (MFB) is a safe and effective method for diagnosing pancreatic cystic lesions (PCLs). This technique shows high technical success and good diagnostic accuracy for PCLs.
Area of Science:
- Gastroenterology
- Endoscopic Ultrasound
- Pancreatic Pathology
Background:
- Pancreatic cystic lesions (PCLs) pose diagnostic challenges in clinical practice.
- Endoscopic ultrasound (EUS) is a key imaging modality for PCL evaluation.
- Sampling PCLs can be difficult, necessitating advanced techniques.
Purpose of the Study:
- To systematically review the technical aspects, safety, and efficacy of EUS-guided through-the-needle micro forceps biopsy (MFB) for PCLs.
- To evaluate the performance of MFB in tissue acquisition and diagnosis of PCLs.
- To assess the safety profile of EUS-guided MFB in PCL sampling.
Main Methods:
- Systematic literature search of PubMed, Embase, and Web of Science databases (September 2019).
- Inclusion of nine studies with 463 patients, excluding case reports and series with <10 patients.
- Analysis of technical success, tissue acquisition yield, diagnostic accuracy, and adverse events.
Main Results:
- High technical success rate of 98.5% for EUS-guided MFB.
- Tissue acquisition yield of 88.2% and diagnostic accuracy of 68.6%.
- Adverse events reported in 9.7% of cases, indicating a favorable safety profile.
Conclusions:
- EUS-guided MFB is a technically feasible and safe procedure for sampling PCLs.
- The technique demonstrates a high diagnostic yield, aiding in the management of PCLs.
- MFB represents a valuable tool for improving the diagnostic accuracy of PCLs via EUS.
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