Endoscopic Ultrasound-Guided Through-the-Needle Biopsy: A Narrative Review of the Technique and Its Emerging Role in Pancreatic Cyst Diagnosis

Autores da FMUP

• Manuel Guilherme Gonçalves Macedo

  Autor

Participantes de fora da FMUP

• Vilas-Boas, Filipe
• Ribeiro, Tiago
• Dhar, Jahnvi
• Samanta, Jayanta
• Sina, Sokol
• Manfrin, Erminia
• Facciorusso, Antonio
• Bellocchi, Maria Cristina Conti
• De Pretis, Nicolo
• Frulloni, Luca
• Crino, Stefano Francesco

Unidades de investigação

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• Medicina

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

Pancreatic cystic lesions (PCLs) pose a diagnostic challenge due to their increasing incidence and the limitations of cross-sectional imaging and endoscopic-ultrasound-guided fine-needle aspiration (EUS-FNA). EUS-guided through the needle biopsy (EUS-TTNB) has emerged as a promising tool for improving the accuracy of cyst type determination and neoplastic risk stratification. EUS-TTNB demonstrates superior diagnostic performance over EUS-FNA, providing critical preoperative information that can significantly influence patient management and reduce unnecessary surgeries. However, the procedure has risks, with an overall adverse event rate of approximately 9%. Preventive measures and further prospective studies are essential to optimize its safety and efficacy. This review highlights the potential of EUS-TTNB to enhance the diagnostic and management approaches for patients with PCLs. It examines the current state of EUS-TTNB, including available devices, indications, procedural techniques, specimen handling, diagnostic yield, clinical impact, and associated adverse events.

Keywords

• mucinous cystic neoplasm; EUS-FNA; pancreatic cancer; cystic fluid analysis; intraductal papillary mucinous neoplasm (IPMN); neuroendocrine tumor