Endoscopy 2019; 51(04): S21
DOI: 10.1055/s-0039-1681228
ESGE Days 2019 oral presentations
Friday, April 5, 2019 08:30 – 10:30: EUS diagnosis Club D
Georg Thieme Verlag KG Stuttgart · New York

HIGH ACCURANCY OF TRANSDUODENAL ENDOSCOPIC FINE NEEDLE BIOPSY USING A 19 G FLEXIBLE NEEDLE: A RETROSPECTIVE MULTICENTER STUDY

G de Nucci
1   Gastroenterology and Endoscopy Unit, ASST Rhodense, Garbagnate Milanese-Milano, Italy
,
MC Petrone
2   Bilio Pancreatic Endoscopy and Endoscopy Ultrasound Unit, San Raffaele Hospital, Milan, Italy
,
N Imperatore
3   Gastroenterology Unit, Federico II University, Naples, Italy
,
E Forti
4   Endoscopy Unit, Ca Grande Niguarda Hospital, Milan, Italy
,
R Grassia
5   Endoscopy Unit, Cremona Hospital, Cremona, Italy
,
S Giovanelli
6   Gastroenterology Unit, Bellaria Hospital, Bologna, Italy
,
L Ottaviani
7   Gastroenterology Unit, Santa Maria Hospital, Perugia, Italy
,
V Mirante
8   Endoscop Unit, Carpi Civil Hospital, Carpi (MO), Italy
,
M Manno
8   Endoscop Unit, Carpi Civil Hospital, Carpi (MO), Italy
,
C Fabbri
6   Gastroenterology Unit, Bellaria Hospital, Bologna, Italy
,
PG Arcidiacono
2   Bilio Pancreatic Endoscopy and Endoscopy Ultrasound Unit, San Raffaele Hospital, Milan, Italy
,
G Manes
1   Gastroenterology and Endoscopy Unit, ASST Rhodense, Garbagnate Milanese-Milano, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Endoscopic ultrasound-guided fine needle aspiration (EUS FNA) is the gold standard to obtain samples from gastrointestinal tract and pancreatic lesions. EUS-FNA is accurate especially when rapid on-site evaluation (ROSE) is performed. The use of EUS-guided fine needle biopsy (EUS FNB) can give a chance to reach a diagnosis. For lesions from the duodenum, it' s recommended the use of a nitinol 19-gauge needle that is more flexible. Recent data shared doubts about feasibility and safety of this needles used through the duodenum. The aim of the study is to evaluate the feasibility, safety and accuracy of 19-gauge nitinol flexible needle in patients with solid lesions punctured from duodenum.

Methods:

We performed a retrospective analysis of prospective databases from eight Italian Endoscopic centres, including consecutive patients with solid lesions who underwent EUS with tissue sampling through duodenum by using 19-gauge needles between 2015 and 2018. All lesions localized at pancreas, nodes, biliary/kidney/liver periduodenal abdominal masses were enrolled in the study.

Results:

201 patients (60.2% males) met the inclusion criteria and were enrolled. EUS-FNB was performed by using the Ex-19G needle in 43.8% of cases and ExF-19G in the remaining 56.2%, through duodenal bulb (47, 23.4%), second (143, 71.1%) and third (11, 5.5%) duodenal portion. FNB was feasible in all cases, while an adequate histology sample was obtained in all but 8 cases (96.1%). 151 lesions were considered malignant and 50 were considered as benign.154 lesions were finally considered as malignant and 47 as benign (8 inadequate samples), leading to a diagnostic accuracy for EUS-FNB of 93.5% (95% IC 89.2%-96.5%), sensitivity of 92.1% (95% IC 86.8%-95.7%), specificity of 100% (95% CI 90.5%-100%), PPV of 100%, NPV of 74% (95% CI 62.8%-82.7%).

Conclusions:

Our data suggest that 19 flexible needles can be used safely through all the duodenum providing a sufficient tissue samples to reach a diagnosis and to perform ancillary techniques.