title: Endoscopic ultrasonography guided-fine needle aspiration for the diagnosis of solid pancreaticobiliary lesions: Clinical aspects to improve the diagnosis.
abstract: Endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA) has been applied to pancreaticobiliary lesions since the 1990s and is in widespread use throughout the world today. We used this method to confirm the pathological evidence of the pancreaticobiliary lesions and to perform suitable therapies. Complications of EUS-FNA are quite rare, but some of them are severe. Operators should master conventional EUS observation and experience a minimum of 20-30 cases of supervised EUS-FNA on non-pancreatic and pancreatic lesions before attempting solo EUS-FNA. Studies conducted on pancreaticobiliary EUS-FNA have focused on selection of suitable instruments (e.g., needle selection) and sampling techniques (e.g., fanning method, suction level, with or without a stylet, optimum number of passes). Today, the diagnostic ability of EUS-FNA is still improving; the detection of pancreatic cancer (PC) currently has a sensitivity of 90%-95% and specificity of 95%-100%. In addition to PC, a variety of rare pancreatic tumors can be discriminated by conducting immunohistochemistry on the FNA materials. A flexible, large caliber needle has been used to obtain a large piece of tissue, which can provide sufficient histological information to be helpful in classifying benign pancreatic lesions. EUS-FNA can supply high diagnostic yields even for biliary lesions or peri-pancreaticobiliary lymph nodes. This review focuses on the clinical aspects of EUS-FNA in the pancreaticobiliary field, with the aim of providing information that can enable more accurate and efficient diagnosis.
authors.affiliation: Hiroyuki Matsubayashi, Toru Matsui, Yohei Yabuuchi, Kenichiro Imai, Masaki Tanaka, Naomi Kakushima, Hiroyuki Ono, Division of Endoscopy, Shizuoka Cancer Center, Suntogun, Shizuoka 411-8777, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Matsubayashi
authors.affiliation: Hiroyuki Matsubayashi, Toru Matsui, Yohei Yabuuchi, Kenichiro Imai, Masaki Tanaka, Naomi Kakushima, Hiroyuki Ono, Division of Endoscopy, Shizuoka Cancer Center, Suntogun, Shizuoka 411-8777, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Matsui
authors.affiliation: Hiroyuki Matsubayashi, Toru Matsui, Yohei Yabuuchi, Kenichiro Imai, Masaki Tanaka, Naomi Kakushima, Hiroyuki Ono, Division of Endoscopy, Shizuoka Cancer Center, Suntogun, Shizuoka 411-8777, Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Yabuuchi
authors.affiliation: Hiroyuki Matsubayashi, Toru Matsui, Yohei Yabuuchi, Kenichiro Imai, Masaki Tanaka, Naomi Kakushima, Hiroyuki Ono, Division of Endoscopy, Shizuoka Cancer Center, Suntogun, Shizuoka 411-8777, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Imai
authors.affiliation: Hiroyuki Matsubayashi, Toru Matsui, Yohei Yabuuchi, Kenichiro Imai, Masaki Tanaka, Naomi Kakushima, Hiroyuki Ono, Division of Endoscopy, Shizuoka Cancer Center, Suntogun, Shizuoka 411-8777, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Hiroyuki Matsubayashi, Toru Matsui, Yohei Yabuuchi, Kenichiro Imai, Masaki Tanaka, Naomi Kakushima, Hiroyuki Ono, Division of Endoscopy, Shizuoka Cancer Center, Suntogun, Shizuoka 411-8777, Japan.
authors.forename: Naomi
authors.initials: N
authors.lastname: Kakushima
authors.affiliation: Hiroyuki Matsubayashi, Toru Matsui, Yohei Yabuuchi, Kenichiro Imai, Masaki Tanaka, Naomi Kakushima, Hiroyuki Ono, Division of Endoscopy, Shizuoka Cancer Center, Suntogun, Shizuoka 411-8777, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Sasaki
authors.affiliation: Hiroyuki Matsubayashi, Toru Matsui, Yohei Yabuuchi, Kenichiro Imai, Masaki Tanaka, Naomi Kakushima, Hiroyuki Ono, Division of Endoscopy, Shizuoka Cancer Center, Suntogun, Shizuoka 411-8777, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ono
mesh_terms: D001661:Biliary Tract Neoplasms / Q000473:pathology* / Q000628:therapy; D002983:Clinical Competence; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000009:adverse effects / Q000295:instrumentation; D004867:Equipment Design; D006801:Humans; D059032:Learning Curve; D009339:Needles; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000628:therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D012307:Risk Factors
keywords: Cancer; Diagnosis; Endoscopic ultrasonography-guided fine-needle aspiration; Pancreatic; Pancreaticobiliary
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