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Technical feasibility, diagnostic yield, and safety of microforceps biopsies during EUS evaluation of pancreatic cystic lesions (with video).
Gastrointest Endosc 2018; 87(5):1263-1269GE

Abstract

BACKGROUND AND AIMS

Through-the-needle microforceps are a recent addition to the EUS armamentarium for evaluation of pancreatic cystic lesions (PCLs). The main aim of this study was to assess the technical feasibility, diagnostic yield, and safety of EUS-guided microforceps biopsy for PCLs.

METHODS

Our electronic endoscopy database was queried to identify patients who underwent EUS-guided FNA (EUS-FNA) of PCLs and microforceps biopsies during the same procedure. A biopsy was done on the wall of the cyst with the microforceps through the 19-gauge needle, and cyst fluid was collected for cytology and carcinoembryonic antigen (CEA) levels. Adverse events were recorded per published American Society for Gastrointestinal Endoscopy criteria.

RESULTS

Twenty-seven patients underwent EUS-FNA and microforceps biopsy of PCLs from February 2016 to July 2017. Fourteen cysts were located in the pancreatic head and/or uncinate, and 13 were located in the body and/or tail region. Microforceps biopsies were technically successful in all cases and provided a pathology diagnosis in 24 of 27 cases (yield 88.9%). Microforceps biopsies diagnosed mucinous cyst in 9 patients (33.3%), serous cystadenoma in 4 (14.8%), neuroendocrine tumor in 1 (3.7%), and benign and/or inflammatory cyst in 10 (37.1%). In 7 patients (26%), microforceps biopsy results drastically changed the diagnosis, providing diagnoses otherwise not suggested by cytology or cyst fluid CEA levels. However, cytology provided a diagnosis of mucinous cyst in 4 cases (14.8%) not detected by microforceps biopsies. No adverse events were noted.

CONCLUSION

Microforceps biopsies were associated with high technical success, and an excellent safety profile and may be a useful adjunctive tool, complementing existing EUS-FNA sampling protocols for PCLs.

Authors+Show Affiliations

Division of Gastroenterology, University of Colorado, Denver, Colorado.Division of Gastroenterology, University of Colorado, Denver, Colorado.Division of Gastroenterology, University of Colorado, Denver, Colorado.Division of Gastroenterology, University of Colorado, Denver, Colorado.Division of Gastroenterology, University of Colorado, Denver, Colorado.Division of Gastroenterology, University of Colorado, Denver, Colorado.Division of Gastroenterology, University of Colorado, Denver, Colorado.Division of Gastroenterology, University of Colorado, Denver, Colorado.Department of Pathology, University of Colorado, Denver, Colorado.Division of Gastroenterology, University of Colorado, Denver, Colorado.

Pub Type(s)

Journal Article
Video-Audio Media

Language

eng

PubMed ID

29309781

Citation

Mittal, Chetan, et al. "Technical Feasibility, Diagnostic Yield, and Safety of Microforceps Biopsies During EUS Evaluation of Pancreatic Cystic Lesions (with Video)." Gastrointestinal Endoscopy, vol. 87, no. 5, 2018, pp. 1263-1269.
Mittal C, Obuch JC, Hammad H, et al. Technical feasibility, diagnostic yield, and safety of microforceps biopsies during EUS evaluation of pancreatic cystic lesions (with video). Gastrointest Endosc. 2018;87(5):1263-1269.
Mittal, C., Obuch, J. C., Hammad, H., Edmundowicz, S. A., Wani, S., Shah, R. J., ... Wagh, M. S. (2018). Technical feasibility, diagnostic yield, and safety of microforceps biopsies during EUS evaluation of pancreatic cystic lesions (with video). Gastrointestinal Endoscopy, 87(5), pp. 1263-1269. doi:10.1016/j.gie.2017.12.025.
Mittal C, et al. Technical Feasibility, Diagnostic Yield, and Safety of Microforceps Biopsies During EUS Evaluation of Pancreatic Cystic Lesions (with Video). Gastrointest Endosc. 2018;87(5):1263-1269. PubMed PMID: 29309781.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Technical feasibility, diagnostic yield, and safety of microforceps biopsies during EUS evaluation of pancreatic cystic lesions (with video). AU - Mittal,Chetan, AU - Obuch,Joshua C, AU - Hammad,Hazem, AU - Edmundowicz,Steven A, AU - Wani,Sachin, AU - Shah,Raj J, AU - Brauer,Brian C, AU - Attwell,Augustin R, AU - Kaplan,Jeffrey B, AU - Wagh,Mihir S, Y1 - 2018/01/06/ PY - 2017/09/20/received PY - 2017/12/03/accepted PY - 2018/1/9/pubmed PY - 2018/11/7/medline PY - 2018/1/9/entrez SP - 1263 EP - 1269 JF - Gastrointestinal endoscopy JO - Gastrointest. Endosc. VL - 87 IS - 5 N2 - BACKGROUND AND AIMS: Through-the-needle microforceps are a recent addition to the EUS armamentarium for evaluation of pancreatic cystic lesions (PCLs). The main aim of this study was to assess the technical feasibility, diagnostic yield, and safety of EUS-guided microforceps biopsy for PCLs. METHODS: Our electronic endoscopy database was queried to identify patients who underwent EUS-guided FNA (EUS-FNA) of PCLs and microforceps biopsies during the same procedure. A biopsy was done on the wall of the cyst with the microforceps through the 19-gauge needle, and cyst fluid was collected for cytology and carcinoembryonic antigen (CEA) levels. Adverse events were recorded per published American Society for Gastrointestinal Endoscopy criteria. RESULTS: Twenty-seven patients underwent EUS-FNA and microforceps biopsy of PCLs from February 2016 to July 2017. Fourteen cysts were located in the pancreatic head and/or uncinate, and 13 were located in the body and/or tail region. Microforceps biopsies were technically successful in all cases and provided a pathology diagnosis in 24 of 27 cases (yield 88.9%). Microforceps biopsies diagnosed mucinous cyst in 9 patients (33.3%), serous cystadenoma in 4 (14.8%), neuroendocrine tumor in 1 (3.7%), and benign and/or inflammatory cyst in 10 (37.1%). In 7 patients (26%), microforceps biopsy results drastically changed the diagnosis, providing diagnoses otherwise not suggested by cytology or cyst fluid CEA levels. However, cytology provided a diagnosis of mucinous cyst in 4 cases (14.8%) not detected by microforceps biopsies. No adverse events were noted. CONCLUSION: Microforceps biopsies were associated with high technical success, and an excellent safety profile and may be a useful adjunctive tool, complementing existing EUS-FNA sampling protocols for PCLs. SN - 1097-6779 UR - https://www.unboundmedicine.com/medline/citation/29309781/Technical_feasibility_diagnostic_yield_and_safety_of_microforceps_biopsies_during_EUS_evaluation_of_pancreatic_cystic_lesions__with_video__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5107(18)30011-7 DB - PRIME DP - Unbound Medicine ER -