title: Endoscopic ultrasound-guided fine needle aspiration and biopsy using a 22-gauge needle with side fenestration in pancreatic cystic lesions.
abstract: BACKGROUND
  Cytologic diagnosis by endoscopic ultrasound-guided fine needle aspiration is associated with low sensitivity and adequacy. A newly designed endoscopic ultrasound-guided fine needle biopsy device, endowed with a side fenestration, is now available.
  
  
  OBJECTIVE
  We carried out a study with the aim of evaluating the feasibility, safety, and diagnostic yield of the 22-gauge needle with side fenestration for endoscopic ultrasound fine needle aspiration and biopsy of pancreatic cystic lesions.
  
  
  METHODS
  58 patients with 60 pancreatic cystic lesions consecutively referred for endoscopic ultrasound guided-fine needle aspiration were enrolled in a prospective, dual centre study, and underwent fine needle aspiration and biopsy with the 22-gauge needle with side fenestration.
  
  
  RESULTS
  Fine needle aspiration and biopsy was technically feasible in all cases. In 39/60 (65%) pancreatic cystic lesions, the specimens were adequate for cyto-histologic assessment. In lesions with solid components, and in malignant lesions, adequacy was 94.4% (p = 0.0149) and 100% (p = 0.0069), respectively. Samples were adequate for histologic evaluation in 18/39 (46.1%) cases. There were only 2 (3.3%) mild complications.
  
  
  CONCLUSIONS
  Fine needle aspiration and biopsy with the 22-gauge needle with side fenestration is feasible, and superior to conventional endoscopic ultrasound-guided fine needle aspiration cytology from cystic fluid, particularly in pancreatic cystic lesions with solid component or malignancy, with a higher diagnostic yield and with no increase in complication rate.
authors.affiliation: Gastroenterology and Endoscopy Unit, ISMETT, Palermo, Italy. Electronic address: lbarresi@ismett.edu.
authors.forename: Luca
authors.initials: L
authors.lastname: Barresi
authors.affiliation: Gastroenterology and Endoscopy Unit, ISMETT, Palermo, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Tarantino
authors.affiliation: Gastroenterology and Endoscopy Unit, ISMETT, Palermo, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Traina
authors.affiliation: Gastroenterology and Endoscopy Unit, ISMETT, Palermo, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Granata
authors.affiliation: Gastroenterology and Endoscopy Unit, ISMETT, Palermo, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Curcio
authors.affiliation: Gastroenterology and Endoscopy Unit, ISMETT, Palermo, Italy.
authors.forename: Neville
authors.initials: N
authors.lastname: Azzopardi
authors.affiliation: Pathology Unit, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Baccarini
authors.affiliation: Pathology Unit, ISMETT, Palermo, Italy.
authors.forename: Rosa
authors.initials: R
authors.lastname: Liotta
authors.affiliation: Pathology Unit, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy.
authors.forename: Adele
authors.initials: A
authors.lastname: Fornelli
authors.affiliation: Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Maimone
authors.affiliation: Department of General Surgery, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy.
authors.forename: Elio
authors.initials: E
authors.lastname: Jovine
authors.affiliation: Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Cennamo
authors.affiliation: Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Fabbri
mesh_terms: D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000473:pathology*; D015331:Cohort Studies; D018282:Cystadenocarcinoma, Mucinous / Q000473:pathology*; D018293:Cystadenoma, Serous / Q000473:pathology*; D003581:Cytodiagnosis; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000295:instrumentation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D018358:Neuroendocrine Tumors / Q000473:pathology*; D010181:Pancreatic Cyst / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000473:pathology*; D010192:Pancreatic Pseudocyst / Q000473:pathology*
keywords: EUS-FNA; Endosonography; Pancreatic cyst