It is reasonable to obtain a histological diagnosis before treating patients who have pancreatic masses and are unsuitable or unwilling to undergo surgery. As the pancreas is a deep seated organ surrounded by other vital structures, it is a challenge for the physician to obtain an adequate specimen for histological examination. Endoscopic ultrasound-guided biopsy of pancreatic masses has been proved to be a safe and effective method. However, if the hospital has no such facilities or patients are unwilling or intolerant of the procedure, computed tomography (CT)-guided biopsy is an alternative method.
A research article to be published on December 21, 2009 in the World Journal of Gastroenterology addresses this question. A research team from Taiwan reviewed 34 CT-guided biopsies in patients with pancreas mass, of whom 24 (71%) had a direct path to the mass without passing through a major organ.
Their results showed tumor tissues were obtained in nine pancreatic biopsies, and histologic specimens for diagnosis were obtained in all cases. An immediate imaging study and clinical follow-up detected neither hemorrhage nor peritonitis. No delayed procedure-related complication was seen during the survival period of all patients.
They drew a conclusion that it is feasible to perform transgastric biopsy of a pancreatic lesion using a large needle.
Reference: Tseng HS, Chen CY, Chan WP, Chiang JH. Percutaneous transgastric computed tomography-guided biopsy of the pancreas using large needles.World J Gastroenterol 2009; 15(47): 5972-5975 http://www.wjgnet.com/1007-9327/15/5972.asp
Correspondence to: Chia-Yuen Chen, MD, Department of Radiology, Taipei Medical University-Municipal Wan Fang Hospital, 111 Hsing-Long Road, Section 3, Taipei 116, Taiwan, China. cychen@wanfang.gov.tw Telephone: +886-2-29307930 Fax: +886-2-29316809
About World Journal of Gastroenterology
World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2008 IF: 2.081. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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World Journal of Gastroenterology