PURPOSE: To evaluate the safety and feasibility of computed tomographic (CT)-guided coaxial fine-needle aspiration biopsy (FNAB) of masses in or around the head of the pancreas with a posterior approach that transgresses the inferior vena cava (IVC). MATERIALS AND METHODS: The authors retrospectively reviewed the records of 29 patients with lesions located within (n = 24) or around (n = 5) the pancreatic head who underwent CT-guided FNAB with the posterior transcaval route due to obstruction of the anterior approach by bowel, liver, and/or other structures. A coaxial needle technique was used, with an outer 18-gauge needle positioned posterior to the IVC and an inner 22-gauge needle traversing the IVC to obtain a biopsy of each lesion. All biopsy specimens were subjected to cytologic evaluation. Medical records of all patients were evaluated for complications. RESULTS: All lesions were safely accessed with the posterior transcaval approach without major complications. The biopsies revealed a malignant process in 21 patients, benign pancreatic cysts in two patients, and pancreatitis in one patient. There were five false-negative biopsy results. Minor complications occurred in four patients (small retroperitoneal hematomas occurred in three and abdominal pain occurred in one). CONCLUSION: CT-guided coaxial FNAB by means of a posterior transcaval approach is a safe method for obtaining samples from lesions in or around the pancreatic head.
PURPOSE: To evaluate the safety and feasibility of computed tomographic (CT)-guided coaxial fine-needle aspiration biopsy (FNAB) of masses in or around the head of the pancreas with a posterior approach that transgresses the inferior vena cava (IVC). MATERIALS AND METHODS: The authors retrospectively reviewed the records of 29 patients with lesions located within (n = 24) or around (n = 5) the pancreatic head who underwent CT-guided FNAB with the posterior transcaval route due to obstruction of the anterior approach by bowel, liver, and/or other structures. A coaxial needle technique was used, with an outer 18-gauge needle positioned posterior to the IVC and an inner 22-gauge needle traversing the IVC to obtain a biopsy of each lesion. All biopsy specimens were subjected to cytologic evaluation. Medical records of all patients were evaluated for complications. RESULTS: All lesions were safely accessed with the posterior transcaval approach without major complications. The biopsies revealed a malignant process in 21 patients, benign pancreatic cysts in two patients, and pancreatitis in one patient. There were five false-negative biopsy results. Minor complications occurred in four patients (small retroperitoneal hematomas occurred in three and abdominal pain occurred in one). CONCLUSION: CT-guided coaxial FNAB by means of a posterior transcaval approach is a safe method for obtaining samples from lesions in or around the pancreatic head.
Authors: Chiang J Tyng; Maria Fernanda A Almeida; Paula N V Barbosa; Almir G V Bitencourt; José Augusto A G Berg; Macello S Maciel; Felipe J F Coimbra; Luiz Henrique O Schiavon; Maria Dirlei Begnami; Marcos D Guimarães; Charles E Zurstrassen; Rubens Chojniak Journal: World J Gastroenterol Date: 2015-03-28 Impact factor: 5.742
Authors: Albert Garcia-Sumalla; Jose C Subtil; Carlos de la Serna; Sandra Maisterra; Jose Ramon Aparicio; Alejandro Enrique Bojorquez; Rafael Leon Montañes; Enrique Vazquez-Sequeiros; Joan B Gornals Journal: Endosc Int Open Date: 2020-11-27