Gut Liver.  2023 Mar;17(2):328-336. 10.5009/gnl220131.

Current Practice Patterns of Endoscopic Ultrasound-Guided Tissue Sampling for Pancreatic Solid Mass in Korea: Outcomes of a National Survey

Affiliations
  • 1Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
  • 2Department of Internal Medicine, Wonkwang University College of Medicine, Iksan,
  • 3Department of Internal Medicine, Hallym University College of Medicine, Anyang, Korea
  • 4Department of Internal Medicine, Kwangju Christian Hospital, Gwangju, Korea
  • 5Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
  • 6Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea
  • 7Department of Internal Medicine, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Korea
  • 8Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea
  • 9Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea
  • 10Department of Internal Medicine, Soonchunhyang University School of Medicine, Bucheon, Korea
  • 11Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
  • 12Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
  • 13Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
  • 14Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
  • 15Department of Internal Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
  • 16Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
  • 17Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea
  • 18Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 19Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea

Abstract

Background/Aims
Although endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) and fine needle biopsy (FNB) are widely used for tissue acquisition of pancreatic solid mass, the optimal strategy of this procedure has not been established yet. The aim of this nationwide study was to investigate the current practice patterns of EUS-FNA/FNB for pancreatic solid mass in Korea.
Methods
The Policy-Quality Management of the Korean Pancreatobiliary Association (KPBA) developed a questionnaire containing 22 questions. An electronic survey consisting of the questionnaire was distributed by e-mail to members registered to the KPBA.
Results
A total of 101 respondents completed the survey. Eighty respondents (79.2%) performed preoperative EUS-FNA/FNB for operable pancreatic solid mass. Acquire needles (60.4%) were used the most, followed by ProCore needles (47.5%). In terms of need size, most respondents (>80%) preferred 22-gauge needles regardless of the location of the mass. Negative suction with a 10-mL syringe (71.3%) as sampling technique was followed by stylet slow-pull (41.6%). More than three needle passes for EUS-FNA/FNB was performed by most respondents (>80%). The frequency of requiring repeated procedure was significantly higher in respondents with a low individual volume (<5 per month, p=0.001). Prophylactic antibiotics were routinely used in 39 respondents (38.6%); rapid on-site pathologic evaluation was used in 6.1%.
Conclusions
According to this survey, practices of EUS-FNA/FNB for pancreatic solid mass varied substantially, some of which differed considerably from the recommendations present in existing guidelines. These results suggest that the development of evidence-based quality guidelines fitting Korean clinical practice is needed to establish the optimal strategy for this procedure.

Keyword

Endoscopic ultrasound-guided fine needle aspiration; Pancreatic neoplasms; Survey; Korea
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