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EUS Diagnostic Puncture

  • Paolo Giorgio ArcidiaconoEmail author
  • Livia Archibugi
Chapter
  • 153 Downloads

Abstract

EUS diagnostic puncture has been performed for over 25 years, impressively evolving with the development of new techniques and devices. In this era when tumors are on the rise and giving the necessity of minimally invasive procedures, EUS has a key role for the diagnosis of lesions arising anywhere near the GI wall. It is currently performed as a routine procedure for outpatients in many instances and is being increasingly used to give an accurate diagnosis with a very low risk of side effects.

In this chapter we will describe indications and contraindications and will go through each single step of the procedure, giving it a very practical guide on how to perform it and how to acquire an excellent competence on it, with the help of evidence-based information and, when lacking, expert opinion.

Keywords

EUS diagnostic puncture Needle FNA FNB Tissue acquisition Tumor Cyst Lesion Cytopathology ROSE 

Supplementary material

Video 26.1

How to perform an EUS diagnostic puncture step-by-step (MP4 404684 kb)

References

  1. 1.
    Vilmann P, Jacobsen GK, Henriksen FW, et al. Endoscopic ultrasonography with guided fine needle aspiration biopsy in pancreatic disease. Gastrointest Endosc. 1992;38:172–3.CrossRefGoogle Scholar
  2. 2.
    Hebert-Magee S, Bae S, Varadarajulu S, et al. The presence of a cytopathologist increases the diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration cytology for pancreatic adenocarcinoma: a meta-analysis. Cytopathology. 2013;24:159–71.CrossRefGoogle Scholar
  3. 3.
    Hewitt MJ, McPhail MJ, Possamai L, et al. EUS-guided FNA for diagnosis of solid pancreatic neoplasms: a meta-analysis. Gastrointest Endosc. 2012;75:319–31.CrossRefGoogle Scholar
  4. 4.
    Puli SR, Bechtold ML, Buxbaum JL, et al. How good is endoscopic ultrasound-guided fine-needle aspiration in diagnosing the correct etiology for a solid pancreatic mass?: a meta-analysis and systematic review. Pancreas. 2013;42:20–6.CrossRefGoogle Scholar
  5. 5.
    Polkowski M, Larghi A, Weynand B, et al. Learning, techniques, and complications of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Guideline. Endoscopy. 2012;44(2):190–206.CrossRefGoogle Scholar
  6. 6.
    Dumonceau JM, Deprez PH, Jenssen C, et al. Indications, results, and clinical impact of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline—updated January 2017. Endoscopy. 2017;49(7):695–714.CrossRefGoogle Scholar
  7. 7.
    Cazacu IM, Luzuriaga Chavez AA, Saftoiu A, et al. A quarter century of EUS-FNA: progress, milestones, and future directions. Endosc Ultrasound. 2018;7(3):141–60.CrossRefGoogle Scholar
  8. 8.
    Veitch AM, Vanbiervliet G, Gershlick AH, et al. Endoscopy in patients on antiplatelet or anticoagulant therapy, including direct oral anticoagulants: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guidelines. Endoscopy. 2016;48(4):385–402.CrossRefGoogle Scholar
  9. 9.
    European Study Group on Cystic Tumours of the Pancreas. European evidence-based guidelines on pancreatic cystic neoplasms. Gut. 2018;67(5):789–804.CrossRefGoogle Scholar
  10. 10.
    Chen JY, Ding QY, Lv Y, et al. Slow-pull and different conventional suction techniques in endoscopic ultrasound-guided fine-needle aspiration of pancreatic solid lesions using 22-gauge needles. World J Gastroenterol. 2016;22(39):8790–7.CrossRefGoogle Scholar
  11. 11.
    Carr RA, Yip-Schneider MT, Simpson RE, et al. Pancreatic cyst fluid glucose: rapid, inexpensive, and accurate diagnosis of mucinous pancreatic cysts. Surgery. 2018;163(3):600–5.CrossRefGoogle Scholar
  12. 12.
    Lee JH, Kim Y, Choi JW, Kim YS. KRAS, GNAS, and RNF43 mutations in intraductal papillary mucinous neoplasm of the pancreas: a meta-analysis. Springerplus. 2016;5:1172.CrossRefGoogle Scholar
  13. 13.
    Raman A, Lennon AM. Cyst fluid biomarkers—diagnosis and prediction of malignancy for cystic lesions of the pancreas. Visc Med. 2018;34(3):178–81.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Pancreato-Biliary Endoscopy and Endosonography DivisionPancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS, Vita-Salute San Raffaele UniversityMilanItaly

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