title: Percutaneous transgastric computed tomography-guided biopsy of the pancreas using large needles.
abstract: OBJECTIVE
  To assess the safety, yield and clinical utility of percutaneous transgastric computed tomography (CT)-guided biopsy of pancreatic tumor using large needles, in selected patients.
  
  
  METHODS
  We reviewed 34 CT-guided biopsies in patients with pancreas mass, of whom 24 (71%) had a direct path to the mass without passing through a major organ. The needle passed through the liver in one case (3%). Nine passes (26%) were made through the stomach. These nine transgastric biopsies which used a coaxial technique (i.e. a 17-gauge coaxial introducer needle and an 18-gauge biopsy needle) were the basis of this study. Immediate and late follow-up CT images to detect complications were obtained.
  
  
  RESULTS
  Tumor tissues were obtained in nine pancreatic biopsies, and histologic specimens for diagnosis were obtained in all cases. One patient, who had a rare sarcomatoid carcinoma, received a second biopsy. One patient had a complication of transient pneumoperitoneum but no subjective complaints. An immediate imaging study and clinical follow-up detected neither hemorrhage nor peritonitis. No delayed procedure-related complication was seen during the survival period of our patients.
  
  
  CONCLUSIONS
  Pancreatic biopsy can be obtained by a transgastric route using a large needle as an alternative method, without complications of peritonitis or bleeding.
authors.affiliation: Department of Radiology, Taipei Veterans General Hospital, Taipei 112, Taiwan, China.
authors.forename: Hsiuo-Shan
authors.initials: HS
authors.lastname: Tseng
authors.forename: Chia-Yuen
authors.initials: CY
authors.lastname: Chen
authors.forename: Wing-P
authors.initials: WP
authors.lastname: Chan
authors.forename: Jen-Huey
authors.initials: JH
authors.lastname: Chiang
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000473:pathology; D011183:Postoperative Complications; D014057:Tomography, X-Ray Computed / Q000379:methods*