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      22-gauge Co-Cr versus stainless-steel Franseen needles for endoscopic ultrasound-guided tissue acquisition in patients with solid pancreatic lesions

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          Abstract

          Background/Aims

          Endoscopic ultrasound-guided tissue acquisition (EUS-TA) using Franseen needles is reportedly useful for its high diagnostic yield. This study compared the diagnostic yield and puncturing ability of EUS-TA using 22-gauge cobalt-chromium (CO-Cr) needles with those of stainless-steel Franseen needles in patients with solid pancreatic lesions.

          Methods

          Outcomes were compared between the 22-gauge Co-Cr Franseen needle (December 2019 to November 2020; group C) and stainless-steel needle (November 2020 to May 2022; group S).

          Results

          A total of 155 patients (group C, 75; group S, 80) were eligible. The diagnostic accuracy was 92.0% in group C and 96.3% in group S with no significant intergroup differences ( p=0.32). The rate of change in the operator (from training fellows to experts) was 20.0% (15/75) in group C and 7.5% (6/80) in group S. Stainless-steel Franseen needles showed less inter-operator difference than Co-Cr needles ( p=0.03).

          Conclusions

          Both Co-Cr and stainless-steel Franseen needles showed high diagnostic ability. Stainless-steel Franseen needles are soft and flexible; therefore, the range of puncture angles can be widely adjusted, making them suitable for training fellows to complete the procedure.

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          Most cited references22

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          A lexicon for endoscopic adverse events: report of an ASGE workshop.

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            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.

            The objective of this study was to evaluate the accuracy of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in diagnosing the correct etiology for a solid pancreatic mass. Data extracted from EUS-FNA studies with a criterion standard (either confirmed by surgery or appropriate follow-up) were selected. Articles were searched in MEDLINE, CINAHL, and Cochrane Central Register of Controlled Trials & Database of Systematic Reviews. Pooling was conducted by both fixed- and random-effects models. Initial search identified 3610 reference articles, of these 360 relevant articles were selected and reviewed. Data were extracted from 41 studies (N = 4766) which met the inclusion criteria. Pooled sensitivity of EUS-FNA in diagnosing the correct etiology for solid pancreatic mass was 86.8% (95% confidence interval [CI], 85.5-87.9). Endoscopic ultrasound-guided FNA had a pooled specificity of 95.8% (95% CI, 94.6-96.7). Positive likelihood ratio of EUS was 15.2 (95% CI, 8.5-27.3), and the negative likelihood ratio was 0.17 (95% CI, 0.13-0.21). Endoscopic ultrasound-guided FNA is an excellent diagnostic tool to detect the correct etiology for solid pancreatic masses. When available, EUS-FNA should be strongly considered as the first diagnostic tool for sampling these lesions to optimize patient management.
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              Slow pull versus suction in endoscopic ultrasound-guided fine-needle aspiration of pancreatic solid masses.

              Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreatic masses is an established procedure for obtaining a pathological specimen. However, application of suction during EUS-FNA is still controversial and the efficacy of the slow-pull technique was recently reported for new core biopsy needles.
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                Author and article information

                Journal
                Clin Endosc
                Clin Endosc
                CE
                Clinical Endoscopy
                Korean Society of Gastrointestinal Endoscopy
                2234-2400
                2234-2443
                March 2024
                26 January 2024
                : 57
                : 2
                : 237-245
                Affiliations
                Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan
                Author notes
                Correspondence: Yuki Tanisaka Department of Gastroenterology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan E-mail: tanisaka1205@ 123456gmail.com
                Author information
                http://orcid.org/0000-0002-2765-3306
                http://orcid.org/0000-0002-5349-0109
                http://orcid.org/0000-0001-9475-0512
                http://orcid.org/0000-0002-0422-6723
                http://orcid.org/0000-0003-2060-5560
                http://orcid.org/0000-0002-8779-3407
                http://orcid.org/0000-0002-3313-7113
                http://orcid.org/0000-0003-4515-5543
                http://orcid.org/0000-0001-7550-5327
                http://orcid.org/0000-0003-4128-9990
                Article
                ce-2023-011
                10.5946/ce.2023.011
                10984738
                38273220
                082627ec-087e-4b0c-9587-521ec7f73d23
                © 2024 Korean Society of Gastrointestinal Endoscopy

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 11 December 2022
                : 21 March 2023
                : 29 March 2023
                Categories
                Original Article

                Radiology & Imaging
                endoscopic ultrasound-guided fine-needle aspiration,endosonography,pancreas,pancreatic neoplasms

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