Endoscopy 2019; 51(04): S44
DOI: 10.1055/s-0039-1681300
ESGE Days 2019 oral presentations
Friday, April 5, 2019 11:00 – 13:00: EUS diagnosis pancreas Club D
Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC ULTRASOUND-THROUGH-THE-NEEDLE MICROFORCEPS BIOPSY IN PANCREATIC CYSTIC LESIONS: A SYSTEMATIC REVIEW

IM Cazacu
1   Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy, Department of Gastroenterology, Craiova, Romania
2   Hepatology and Nutrition, University of Texas, MD Anderson Cancer Center, Department of Gastroenterology, Houston, United States
,
D Vasile Balaban
3   'Carol Davila' University of Medicine and Pharmacy, Internal Medicine and Gastroenterology Clinic, Bucharest, Romania
4   'Dr. Carol Davila' Central Military Emergency University Hospital, Department of Gastroenterology, Bucharest, Romania
,
L Pinte
5   Colentina Clinical Hospital, Internal Medicine Department, Bucharest, Romania
,
M Jinga
3   'Carol Davila' University of Medicine and Pharmacy, Internal Medicine and Gastroenterology Clinic, Bucharest, Romania
4   'Dr. Carol Davila' Central Military Emergency University Hospital, Department of Gastroenterology, Bucharest, Romania
,
MS Bhutani
2   Hepatology and Nutrition, University of Texas, MD Anderson Cancer Center, Department of Gastroenterology, Houston, United States
,
A Saftoiu
1   Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy, Department of Gastroenterology, Craiova, Romania
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 

Aims:

The Moray microforceps biopsy device (MFB) is a disposable tissue acquisition device that can be passed through a 19-gauge needle and it has been recently introduced to facilitate the EUS-guided biopsy of pancreatic cystic lesions (PCL). Our aim was to perform a systematic review of studies evaluating the technical aspects, safety and efficacy of the EUS-guided microforceps biopsy for PCLs.

Methods:

A literature search was performed in three major databases, PubMed, Embase and Web of Science in October, 2018. The search terms used were: “through-the-needle”, “biopsy forceps”, “microforceps”, “endoscopic ultrasound”, and “endosonography”. Case reports and case series with less than 15 patients were excluded from the analysis.

Results:

Altogether 7 retrospective studies reporting on 269 patients were included. Mean age of the patients was 66.3 years, with a slight female predominance (59.5%). The size of the PCLs ranged from 11 to 88 mm and most of them were located in the head or body of the pancreas (69%).

Technical success of EUS-guided MFB was reported in 258/269 cases (96%). Main reasons for technical difficulties were inability to access the cyst while the echoendoscope was fully flexed, difficulty to push the instrument through the needle, and difficulty to visualize the forceps on EUS scan. The tissue acquisition yield reported was 88% (171/194). EUS-guided MFB was able to establish the correct final diagnosis in 151 PCLs out of 212 (diagnostic accuracy, 71%).

Nineteen cases with adverse events (7%) were reported: abdominal pain (1.8%), intracystic hemorrhage (3%), mild acute pancreatitis (1.5%), postprocedural infection (0.7%) and atrial fibrillation after procedure (0.3%).

Conclusions:

EUS-guided MFB is technically feasible, safe and has a high diagnostic accuracy for PCLs. These results should be, however, interpreted with caution. Given the novelty of EUS-guided MFB, further ongoing studies are expected to offer a better understanding of its safety profile and diagnostic accuracy.