Endoscopic ultrasound-guided fine-needle aspiration biopsy - Recent topics and technical tips

Figure 3 Distal cholangiocarcinoma where the “blood vessel push-aside” method made it possible to ensure the puncture route. A: It was difficult to ensure the puncture route due to blood vessels around the lesion; B: Pushing the puncture needle up against the back side of the blood vessels to push them aside made it possible to ensure the puncture route; C: Puncture was made on the far side of the blood vessels (left side of the endoscopic ultrasound image); D: Lifting of the raising base and an upward angle ensured the puncture route.