Department of Gastroenterology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
Department of Gastroenterology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
BMJ Open Gastroenterol. 2023 Jun;10(1). doi: 10.1136/bmjgast-2023-001184.
Endoscopic ultrasound-guided through-the-needle microbiopsy (EUS-TTNB) forceps is a recent development that facilitates sampling of the walls of pancreatic cystic lesions (PCL) for histological analysis. We aimed to assess the impact of EUS-TTNB and its influence on patient management in a tertiary pancreas centre.
A prospective database of consecutive patients who underwent EUS-TTNB from March 2020 to August 2022 at a tertiary referral centre was retrospectively analysed.
Thirty-four patients (22 women) were identified. Technical success was achieved in all cases. Adequate specimens for histological diagnosis were obtained in 25 (74%) cases. Overall, EUS-TTNB led to a change in management in 24 (71%) cases. Sixteen (47%) patients were downstaged, with 5 (15%) discharged from surveillance. Eight (24%) were upstaged, with 5 (15%) referred for surgical resection. In the 10 (29%) cases without change in management, 7 (21%) had confirmation of diagnosis with no change in surveillance, and 3 (9%) had insufficient biopsies on EUS-TTNB. Two (6%) patients developed post-procedural pancreatitis, and 1 (3%) developed peri-procedural intracystic bleeding with no subsequent clinical sequelae.
EUS-TTNB permits histological confirmation of the nature of PCL, which can alter management outcomes. Care should be taken in patient selection and appropriately consented due to the adverse event rate.
内镜超声引导下经针活检钳（EUS-TTNB）是一种新的发展，它方便了对胰腺囊性病变（PCL）壁进行组织学分析的取样。我们旨在评估 EUS-TTNB 及其对三级胰腺中心患者管理的影响。
回顾性分析了 2020 年 3 月至 2022 年 8 月在三级转诊中心接受 EUS-TTNB 的连续患者的前瞻性数据库。
确定了 34 名患者（22 名女性）。所有病例均获得技术成功。25 例（74%）获得了足够的组织学诊断标本。总的来说，EUS-TTNB 导致 24 例（71%）患者的管理发生变化。16 例（47%）患者降级，5 例（15%）从监测中出院。8 例（24%）升级，5 例（15%）转外科切除。在管理无变化的 10 例（29%）病例中，7 例（21%）通过 EUS-TTNB 确认诊断，监测无变化，3 例（9%）EUS-TTNB 活检标本不足。2 例（6%）患者发生术后胰腺炎，1 例（3%）发生围手术期囊内出血，无后续临床后果。
EUS-TTNB 允许对 PCL 的性质进行组织学确认，这可以改变管理结果。由于不良事件发生率，应谨慎选择患者并适当同意。
