Comparison of Endoscopic Ultrasonography Evaluation of suspected Pancreaticobiliary Malignancy in Patient with or without Biliary Decompression

Document Type : Original Article

Authors

1 Department of Hepatology, Gastroenterology, and Infectious Diseases Faculty of Medicine- Benha University.

2 Department of Gastroenterology, and Infectious Diseases Faculty of Medicine- Benha University.

3 Department of Internal Medicine -Tanta University

4 Department of pathology Faculty of Medicine- Tanta University.

5 Department of pathologty , Faculty of Medicine - Banha University

6 Department of Hepatology gastroenterology , Elmehalla Liver Educational Teaching Hospital.

7 Department of Internal Medicine department -Tanta University.

Abstract

Background: Endoscopic ultrasound (EUS) is a modern modality aids in the diagnosis and treatment of pancreatic and biliary diseases. It also allows tissue sampling and staging.
AIM: to compare the diagnostic accuracy of Endoscopic Ultrasonography (EUS) guided fine needle aspiration (FNA) before and after biliary decompression in suspected pancreaticobiliary malignancy.
Patients and methods: this prospective study was conducted in Tanta University (internal medicine department) and Banha University (hepatology, gastroenterology and infectious disease department) on (120) patients with suspected pancreaticobilliary malignancy and they classified into two groups based on the presence or absence of biliary stent. Results: comparing between both groups using the univariate regression analysis, increasing the tumor size, increasing the number of passes and use of 22-guage needle were shown as predictors associated with accurate diagnosis by EUS. However, with application of multivariate regression analysis, increasing the tumor size and use of 22-guage needle were shown as independent predictors associated with accurate diagnosis by EUS. the presence of stent did not influence the accuracy of diagnosis.Conclusion: Endoscopic ultrasound fine-needle aspiration is considered a highly accurate and reliable diagnostic technique for suspected pancreaticobiliary malignancy. Pre-EUS stenting of biliary obstruction due to pancreaticobiliary malignancy didn’t influence the rate of tissue diagnosis.

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