Fine needle biopsy of the pancreas – dilemmas surrounding the sampling method

Ultrasound-guided fine-needle biopsy of the pancreas as a diagnostic method began to spread in the 1980s, as it is a relatively simple procedure that causes the least damage to the pancreatic tissue, which is sensitive to physical effects, and is therefore the gentlest, least-complicated, and most effective diagnostic procedure among invasive diagnostic options.

With the development of technology, about 15-20 years later, EUS sampling became more and more popular. The diagnostic effectiveness of the two methods is similar, but the advantage of the latter can be that a sample can be taken from smaller lesions that are not clearly visible with abdominal US. However, the spread of EUS-guided biopsies is increasingly displacing percutaneous biopsy from the diagnostic line. In a few years, the number of percutaneous pancreatic biopsies, which had been common until then, also decreased drastically in the cytology laboratory of SE PIBOI. In our article, we try to explore the cause of this phenomenon. We compared the results of pancreatic biopsy samples examined in our institute between 2018-2023, over a period of 6 years, with data from other working groups.

According to our findings, the omission of percutaneous pancreatic biopsies is not justified, the arguments listed against biopsies taken in this way are based on unfounded, biased dogmas. Our goal with this article is to return the use of US-guided percutaneous pancreatic biopsies to the diagnostic line in a dignified manner for the sake of both patients and cost-effectiveness.