Slow-pull using a fanning technique is more useful than the standard suction technique in EUS-guided fine needle aspiration in pancreatic masses

Jae Min Lee, Hong Sik Lee, Jong Jin Hyun, Jung Min Lee, In Kyung Yoo, Seung Han Kim, Hyuk Soon Choi, Eun Sun Kim, Bora Keum, Yeon Seok Seo, Yoon Tae Jeen, Hoon Jai Chun, Soon Ho Um, Chang Duck Kim

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

Background/Aims: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is useful for obtaining pancreatic mass samples. The combination of modified techniques (i.e., slow-pull technique and fanning technique) may improve the quality of the sample obtained by EUS-FNA. We investigated the effectiveness of a combined slow-pull fanning technique in EUS-FNA for pancreatic mass. Methods: This prospective comparative study investigated EUS-FNA performed for pancreatic solid masses between August 2015 and July 2016. Pairwise specimens were alternately obtained using the following two techniques for targeted pancreatic lesions: standard suction or slow-pull with fanning. We compared the specimen quality, blood contamination, and diagnostic accuracy of these techniques. Results: Forty-eight consecutive patients were included (29 men; mean age, 68.1±11.9 years), and 96 pancreatic mass specimens were obtained. The slow-pull with fanning technique had a significantly superior diagnostic accuracy than the suction technique (88% vs 71%, p=0.044). Furthermore, blood contamination was significantly reduced using the slow-pull with fanning technique (ratio of no or slight contamination, 77% vs 56%, p=0.041). No difference was observed in the acquisition of adequate cellularity between the groups. In the subgroup analysis, the tumor size and sampling technique were related to the EUSFNA diagnostic accuracy. Conclusions: The slow-pull with needle fanning technique showed a good diagnostic yield for EUS-FNA for pancreatic mass. This technique can be useful for performing EUS-guided sampling for diagnosing pancreatic disease.

Original languageEnglish
Pages (from-to)360-366
Number of pages7
JournalGut and liver
Volume12
Issue number3
DOIs
Publication statusPublished - 2018 May

Keywords

  • Biopsy
  • Endosonography
  • Fine-needle
  • Pancreas

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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