Document resource
Background There is limited data regarding the benefit of one suction technique over the other during EUS-guided biopsy of solid pancreatic lesions (SPL). The aim of this study was to compare the performance of no suction (NS), v/s wet heparin suction (WS) and slow stylet pull (SSP) technique when using a 22G Franssen tip needle for SPL fine needle biopsy (FNB).Methods This single-centre randomised controlled trial enrolled consecutive patients with SPL ( n = 45) from a tertiary care centre in India. Three passes were taken using a 22G Franssen tip needle using all three sampling techniques (NS, WS, SSP) in a randomized sequence in each patient. The diagnostic efficacy, tissue integrity, blood contamination, and risk of adverse events between the three suction techniques were compared.Results A total of 45 patients were analyzed. After three passes, the overall sensitivity of sampling was 96.8%, and the accuracy was 95.3%. No significant difference was found in diagnostic efficacy among the three techniques [sensitivity (WS vs SSP vs NS, 96.14% vs. 91.06% vs. 94.23, P = 0.22; accuracy, 93.91% vs. 92.6% vs. 91.8%, P = 0.31). The tissue integrity was also comparable in all techniques (93.62% vs. 91.62% vs. 96.9%, P = 0.27). The pathological diagnosis attained from the biopsy specimens was pancreatic malignancy (n =32), NET (n=5), pancreatic tuberculosis (n = 2), metastatic renal carcinoma (n=2), normal pancreatic tissue (n=2), and 1 sample was inadequate for diagnosis and 1 had smooth muscle cells (IDDF2026-ABS-0320 Figure 1). The WS had a higher degree of blood contamination compared to the SSP and NS technique (P = 0.04). There was no adverse event in any of the patients. Conclusions There is no added benefit of WS and SSP compared to the NS technique, with increased blood contamination with the WS technique, for EUS -FNB of SPL using a 22G Franseen tip needle.Abstract IDDF2026-ABS-0320 Figure 1