Año 2024 / Volumen 116 / Número 12
Original
Endoscopic ultrasound-guided biopsy of healthy pig pancreas - Towards the histological diagnosis of chronic pancreatitis

664-670

DOI: 10.17235/reed.2024.10557/2024

Julio Iglesias-García, Yessica Domínguez-Novoa, Héctor Lazare-Iglesias, Antonio González-Cantalapiedra, Ihab Abdulkader-Nallib, Óscar Varela-López, José Lariño-Noia, Enrique Domínguez-Muñoz,

Resumen
Background: diagnosis of early chronic pancreatitis (CP) is a challenge due to the lack of accurate methods. The ability of endoscopic ultrasound (EUS) guided biopsy to obtain pancreatic core tissue samples in patients with minimal changes of CP and its potential use for the histological diagnosis of early CP are unknown. The aim of the study was to evaluate the ability of different EUS-guided biopsy core needles to obtain histological samples of healthy pig pancreas. Methods: an observational, feasibility, comparative, single blind study was performed in two pigs, of two months old, weighing 22 kg. EUS-guided biopsy was performed from the body of the pancreas. Core needles of 19-gauge, 20-gauge, 22-gauge and 25-gauge were used. Two passes with ten to-and-fro movements were performed with each needle. Samples were evaluated by blinded expert pathologists. Primary end point was the ability to obtain core tissue samples. Secondary end point included fragmentation, core size, amount of blood and sample quality for histological assessment. Results: a core tissue sample was obtained with 19-gauge, 20-gauge and 22-gauge core needles. The mean size of the tissue core was 2.38 ± 1.06 mm (range 1-4 mm). Tissue samples were considered as adequate for histological evaluation with 19-gauge and 22-gauge Franseen and fork-tip and 20-gauge reverse bevel needles. No complications related to the procedure were reported. Conclusions: obtaining a core tissue sample of healthy pancreas by EUS-guided biopsy is feasible. Whether EUS-guided biopsy using these needles is accurate and safe for the histological diagnosis of early CP deserves further investigations.
Resumen coloquial
The diagnosis of chronic pancreatitis at early stages is a clinical challenge, mainly because of the problems for a histological confirmation. Endoscopic ultrasound (EUS) is considered as the best technique in this setting, also providing with the option to perform a guided biopsy. In our study, we performed an EUS guided biopsy of 2 healthy pigs with the aim to obtain histological samples of healthy pig pancreas. We used all core needles available. We could obtain a core tissue sample for with 19-gauge, 20-gauge and 22-gauge core needles, being the pancreatic samples considered adequate for a histological evaluation with the Franseen and fork-tip and the reverse bevel needles. No complications were observed related to the procedure.
Nuevo comentario
Comentarios
No hay comentarios para este artículo.
Bibliografía
1. Whitcomb DC, Frulloni L, Garg P, Greer JB, Schneider A, Yadav D, et al. Chronic pancreatitis: An international draft consensus proposal for a new mechanistic definition. Pancreatol Off J Int Assoc Pancreatol IAP Al. 2016 Apr;16(2):218–24.
2. Löhr JM, Dominguez-Munoz E, Rosendahl J, Besselink M, Mayerle J, Lerch MM, et al. United European Gastroenterology evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis (HaPanEU). United Eur Gastroenterol J. 2017;5(2):153–99.
3. Whitcomb DC, Shimosegawa T, Chari ST, Forsmark CE, Frulloni L, Garg P, et al. International consensus statements on early chronic Pancreatitis. Recommendations from the working group for the international consensus guidelines for chronic pancreatitis in collaboration with The International Association of Pancreatology, American Pancreatic Association, Japan Pancreas Society, PancreasFest Working Group and European Pancreatic Club. Pancreatol Off J Int Assoc Pancreatol IAP Al. 2018 May 21;
4. Catalano MF, Sahai A, Levy M, Romagnuolo J, Wiersema M, Brugge W, et al. EUS-based criteria for the diagnosis of chronic pancreatitis: the Rosemont classification. Gastrointest Endosc. 2009 Jun;69(7):1251–61.
5. Dominguez-Muñoz JE, Iglesias-Garcia J, Castiñeira Alvariño M, Luaces Regueira M, Lariño-Noia J. EUS elastography to predict pancreatic exocrine insufficiency in patients with chronic pancreatitis. Gastrointest Endosc. 2015 Jan;81(1):136–42.
6. Iglesias-Garcia J, Domínguez-Muñoz JE, Castiñeira-Alvariño M, Luaces-Regueira M, Lariño-Noia J. Quantitative elastography associated with endoscopic ultrasound for the diagnosis of chronic pancreatitis. Endoscopy. 2013 Oct;45(10):781–8.
7. Domínguez-Muñoz JE, Lariño-Noia J, Alvarez-Castro A, Nieto L, Lojo S, Leal S, et al. Endoscopic ultrasound-based multimodal evaluation of the pancreas in patients with suspected early chronic pancreatitis. United Eur Gastroenterol J. 2020 Aug;8(7):790–7.
8. Sekine M, Tanaka A, Akimoto M, Miura T, Fujiwara J, Noda H, et al. A Comparative Study of Endoscopic Ultrasonography and Histopathology Images for the Diagnosis of Early Chronic Pancreatitis. Pancreas. 2021 Sep 1;50(8):1173–9.
9. Takasaki Y, Ishii S, Fujisawa T, Ushio M, Takahashi S, Yamagata W, et al. Endoscopic Ultrasonography Findings of Early and Suspected Early Chronic Pancreatitis. Diagn Basel Switz. 2020 Nov 27;10(12):E1018.
10. Yamabe A, Irisawa A, Bhutani MS, Sato A, Maki T, Takasaki Y, et al. Validity of Endoscopic Ultrasound Findings of Chronic Pancreatitis: Evaluation from the Viewpoint of Disease Risk Factors. Digestion. 2019 Dec 4;1–9.
11. Issa Y, Kempeneers MA, van Santvoort HC, Bollen TL, Bipat S, Boermeester MA. Diagnostic performance of imaging modalities in chronic pancreatitis: a systematic review and meta-analysis. Eur Radiol. 2017 Sep;27(9):3820–44.
12. Mel Wilcox C, Gress T, Boermeester M, Masamune A, Lévy P, Itoi T, et al. International consensus guidelines on the role of diagnostic endoscopic ultrasound in the management of chronic pancreatitis. Recommendations from the working group for the international consensus guidelines for chronic pancreatitis in collaboration with the International Association of Pancreatology, the American Pancreatic Association, the Japan Pancreas Society, and European Pancreatic Club. Pancreatol Off J Int Assoc Pancreatol IAP Al. 2020 Jul;20(5):822–7.
13. Trikudanathan G, Munigala S, Barlass U, Malli A, Han Y, Sekulic M, et al. Evaluation of Rosemont criteria for non-calcific chronic pancreatitis (NCCP) based on histopathology - A retrospective study. Pancreatol Off J Int Assoc Pancreatol IAP Al. 2017 Feb;17(1):63–9.
14. Luaces-Regueira M, Iglesias-García J, Lindkvist B, Castiñeira-Alvariño M, Nieto-García L, Lariño-Noia J, et al. Smoking as a risk factor for complications in chronic pancreatitis. Pancreas. 2014 Mar;43(2):275–80.
15. Göltl P, Murillo K, Simsek O, Wekerle M, Ebert MP, Schneider A, et al. Impact of alcohol and smoking cessation on the course of chronic pancreatitis. Alcohol Fayettev N. 2023 Nov 25;S0741-8329(23)00336-1.
16. Chen YI, Chatterjee A, Berger R, Kanber Y, Wyse J, Lam E, et al. Endoscopic ultrasound (EUS)-guided fine needle biopsy alone vs. EUS-guided fine needle aspiration with rapid onsite evaluation in pancreatic lesions: a multicenter randomized trial. Endoscopy. 2022 Jan;54(1):4–12.
17. Chung MJ, Park SW, Kim SH, Cho CM, Choi JH, Choi EK, et al. Clinical and Technical Guideline for Endoscopic Ultrasound (EUS)-Guided Tissue Acquisition of Pancreatic Solid Tumor: Korean Society of Gastrointestinal Endoscopy (KSGE). Clin Endosc. 2021 Mar;54(2):161–81.
18. Crinò SF, Le Grazie M, Manfrin E, Conti Bellocchi MC, Bernardoni L, Granato A, et al. Randomized trial comparing fork-tip and side-fenestrated needles for EUS-guided fine-needle biopsy of solid pancreatic lesions. Gastrointest Endosc. 2020 Sep;92(3):648-658.e2.
19. Dumonceau JM, Deprez PH, Jenssen C, Iglesias-Garcia J, Larghi A, Vanbiervliet G, et al. Indications, results, and clinical impact of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline - Updated January 2017. Endoscopy. 2017 Jul;49(7):695–714.
20. Sweeney J, Soong L, Goyal A. Endoscopic ultrasound-guided tissue acquisition of solid mass lesions of the pancreas: A retrospective comparison study of fine-needle aspiration and fine-needle biopsy. Diagn Cytopathol. 2020 Apr;48(4):322–9.
Artículos relacionados

Carta

Gastric ectopic pancreas with a pseudocyst

DOI: 10.17235/reed.2024.10339/2024

Carta

Extraosseous Ewing’s sarcoma of the pancreas

DOI: 10.17235/reed.2024.10281/2024

Carta

Quiste linfoepitelial pancreático

DOI: 10.17235/reed.2024.10091/2023

Imagen en Patología Digestiva

Imaging of pancreatic desmoid fibromatosis by endoscopic ultrasound

DOI: 10.17235/reed.2023.9792/2023

Imagen en Patología Digestiva

An unusual cause of a protuberant lesion of the gastric antrum

DOI: 10.17235/reed.2022.8771/2022

Carta

Tumor de Frantz-Gruber: una neoplasia pancreática infrecuente

DOI: 10.17235/reed.2021.8345/2021

Carta

Paniculitis pancreática

DOI: 10.17235/reed.2019.6116/2018

Imagen en Patología Digestiva

Neoplasia papilar mucinosa intraductal de conducto principal en un paciente con páncreas divisum

DOI: 10.17235/reed.2019.5959/2018

Carta al Editor

Páncreas ectópico: una masa intestinal muy infrecuente

DOI: 10.17235/reed.2017.5353/2017

Carta al Editor

Tumores neuroendocrinos de páncreas: factores pronósticos

DOI: 10.17235/reed.2017.5109/2017

Editorial

Tumores neuroendocrinos del páncreas: no tan raros y no tan benignos

DOI: 10.17235/reed.2016.4672/2016

Instrucciones para citar
Iglesias-García J, Domínguez-Novoa Y, Lazare-Iglesias H, González-Cantalapiedra A, Abdulkader-Nallib I, Varela-López Ó, et all. Endoscopic ultrasound-guided biopsy of healthy pig pancreas - Towards the histological diagnosis of chronic pancreatitis. 10557/2024


Descargar en un gestor de citas

Descargue la cita de este artículo haciendo clic en uno de los siguientes gestores de citas:

Métrica
Este artículo ha sido visitado 1695 veces.
Este artículo ha sido descargado 89 veces.

Estadísticas de Dimensions


Estadísticas de Plum Analytics

Ficha Técnica

Recibido: 23/05/2024

Aceptado: 12/08/2024

Prepublicado: 05/09/2024

Publicado: 13/12/2024

Tiempo de revisión del artículo: 67 días

Tiempo de prepublicación: 105 días

Tiempo de edición del artículo: 204 días


Compartir
Este artículo aun no tiene valoraciones.
Valoración del lector:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
La REED es el órgano oficial de la Sociedad Española de Patología Digestiva, la SociedadEspañola de Endoscopia Digestiva y la Asociación Española de Ecografía Digestiva
Política de cookies Política de Privacidad Aviso Legal © Copyright 2025 y Creative Commons. Revista Española de Enfermedades Digestivas