Ultrasound-guided fine needle aspiration and core needle biopsy for pancreatic neoplasms and surrounding-pancreatic neoplasms

Nguyen Thi Khoi1, Nguyen Thi Thu Thao1, Ngo Le Lam2, Vu Dang Luu3, Pham Minh Thong3,
1 Center for Diagnostic Imaging, Bach Mai Hospital
2 Doctor of K Hospital
3 Diagnostic Imaging Department - Radiology Center, Bach Mai Hospital

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Abstract

SUMMARY
Solid pancreatic or peripancreatic lesions are common diseases . All most of them need to pathology diagnosis. provides an alternative pathway for adequate specimen acquisition. Because of the deep retroperitoneal location, we usually use endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) or inderect percutaneous core needle biopsy (CNB) . Both of them have disadvantages on their own. the sensitivity and specificity of EUS-guided FNA (EUS-FNA) for pancreatic neoplasms has were 85% and 98%, respectively and The complication rate of EUS-FNA is approximately 1%–2% [1]. However, one limitation related to this technique is that it often only provides a cytologic specimen with scant cellularity and lack of histologic architecture, which restrains us from making a complete tissue analysis for diagnosis and grade differentiation. the sensitivity and specificity of inderect percutaneous CNB for pancreatic neoplasms has were 90,4% and 92% respectively [2], overcome the disadvantages of EUS-FNA [3]. But it is relatively risky and difficult especially for those who do not have much experience.
Reaching through the liver, spleen and kidneys increases the risk of bleeding. Approaching through the stomach and intestine, the incidence of complications can reach 15.3% [4], [5] including: infection, peritonitis and gastrointestinal perforation. Access
through the gallbladder has a high risk of cholestatic and cholecystitis [4]. Derect percutaneous CNB/ FNA is a new technique which can make good the risks of two technique before. In this review, we will present some cases of FNA and biopsy of solid pancreatic or peripancreatic lesions by direct access approach, thereby
showing about techniques, diagnostic effectiveness as well as complications of percutaneous CNB/ FNA

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References

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