Endoscopic ultrasound trends of solid pancreatic lesions in Gulf Cooperation Council countries

Pancreatic cancer and other solid pancreatic lesions present significant diagnostic challenges owing to their deep anatomical location and nonspecific symptoms. Endoscopic ultrasound (EUS) has emerged as a critical modality for high-resolution imaging and tissue sampling of pancreatic lesions. However, comprehensive data on its utilization and findings in Gulf Cooperation Council (GCC) countries remain scarce. This study aimed to evaluate the demographic characteristics, clinical presentations, and diagnostic outcomes of solid pancreatic lesions assessed via EUS in GCC countries.

A retrospective, descriptive analysis was conducted on 551 patients who underwent EUS for the evaluation of solid pancreatic lesions between 2020 and 2024 across multiple healthcare institutions in the GCC countries. Demographic data, clinical symptoms, imaging findings, and diagnostic outcomes were also collected. Statistical analyses included descriptive statistics, Chi-squared tests for categorical variables, and Mann-Whitney U tests for non-normally distributed continuous variables.

A total of 551 patients (mean age 61.5±13.7 years; n=330 males, 59.9%) were included. Most were symptomatic (n=499, 90.6%), with abdominal pain (n=354, 64.2%) being the most common symptom. Computed tomography was the initial diagnostic modality in the majority (n=469, 85.1%). Lesions were most frequently located in the pancreatic head/uncinate on imaging (n=329, 59.7%) and EUS (n=361, 65.6%). Vascular involvement was observed in 260 (47.2%) radiologically and 226 (41.1%) on EUS. Lesion size was smaller on EUS (34 vs. 37 mm, P=0.008), while side branch dilation was more often detected (P<0.001). The most common diagnosis was pancreatic ductal adenocarcinoma (n=417, 80.1%), followed by neuroendocrine tumors (n=49, 9.4%).

EUS plays a pivotal role in diagnosing solid pancreatic lesions in the GCC countries, offering safe and effective lesion characterization and tissue sampling. Standardized protocols and further molecular research are warranted to enhance diagnostic precision and outcomes in pancreatic adenocarcinoma.