Incidental Finding of Gastric Lesions During Pancreatobiliary Endoscopic Ultrasonography

Gastric lesions may be incidentally detected during pancreatobiliary endoscopic ultrasonography (PB-EUS). We aimed to clarify the detection rate of gastric lesions and the impact of awareness on the detection of gastric lesions during PB-EUS.

We retrospectively analyzed consecutive patients who underwent PB-EUS (1932 procedures, 1220 patients). We compared the detection rate of incidental gastric lesions and documentation of gastric findings between the groups without and with gastric screening during PB-EUS: former group (2009-2014: 505 procedures, 409 patients) and latter group (2015-2020: 1427 procedures, 918 patients), respectively.

Thirteen gastric lesions were incidentally detected during PB-EUS, all in the latter group, including gastric cancer (n = 1), malignant lymphoma (n = 1), gastric adenoma (n = 1), gastric submucosal tumor (n = 2), and gastric ulcer (n = 8). The detection rate of gastric lesions was significantly higher in the latter group than in the former group per procedure (0.91% vs. 0%, P = 0.027) and per patient (1.41% vs. 0%, P = 0.015), and gastric findings were significantly more commonly described in patients' medical records (39.8% vs. 2.97%, P < 0.001).

Gastric lesions may be encountered during PB-EUS. A quick screening during PB-EUS improved the detection rate of gastric lesions, presumably due to increased awareness of gastric lesions during the procedure.