title: Endoscopic ultrasound-guided fine needle aspiration with 22- and 25-gauge needles in solid pancreatic masses: a prospective comparative study with randomisation of needle sequence.
abstract: BACKGROUND
  The difference in the diagnostic accuracy of 22- versus 25-gauge needles in EUS-FNA is not clear.
  
  
  OBJECTIVE
  To compare the rates of technical success, diagnostic accuracy and complications of EUS-FNA performed with 22-gauge and 25-gauge needles on the same solid pancreatic mass.
  
  
  METHODS
  All patients with solid pancreatic masses evaluated from September 2007 to December 2008 were enrolled and underwent EUS-FNA with both 22- and 25-gauge needles with randomisation of needle sequence. The accuracy of the EUS-FNA was determined by comparing the cytological results with the final surgical pathological diagnoses or with the results of a clinical follow-up. A cytological score with different qualitative parameters was created, and a comparison between these parameters was carried out for each needle.
  
  
  RESULTS
  Fifty patients with 50 pancreatic masses were recruited. Technical success was 100% and no complications occurred. Diagnostic accuracy was 94% and 86% for the 25- and 22-gauge needles, respectively. Analysis of the cytological score showed a tendency towards the 25-gauge needle, although the difference was not statistically significant.
  
  
  CONCLUSIONS
  EUS-FNA performed with 22- or 25-gauge needles had the same diagnostic accuracy. Our study results confirm a significant trend towards a better cytological diagnosis for the 25-gauge needle.
authors: Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy. carlo.fabbri@ausl.bologna.it
authors: Carlo
authors: C
authors: Fabbri
authors: Anna Maria
authors: AM
authors: Polifemo
authors: Carmelo
authors: C
authors: Luigiano
authors: Vincenzo
authors: V
authors: Cennamo
authors: Paola
authors: P
authors: Baccarini
authors: Guido
authors: G
authors: Collina
authors: Adele
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authors: Fornelli
authors: Sandro
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authors: Macchia
authors: Nicola
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authors: Zanini
authors: Elio
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authors: Jovine
authors: Marta
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authors: Fiscaletti
authors: Angela
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authors: Alibrandi
authors: Nicola
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authors: D'Imperio