Brief Article
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Dec 21, 2009; 15(47): 5972-5975
Published online Dec 21, 2009. doi: 10.3748/wjg.15.5972
Percutaneous transgastric computed tomography-guided biopsy of the pancreas using large needles
Hsiuo-Shan Tseng, Chia-Yuen Chen, Wing P Chan, Jen-Huey Chiang
Hsiuo-Shan Tseng, Jen-Huey Chiang, Department of Radiology, Taipei Veterans General Hospital, Taipei 112, Taiwan, China; Department of Radiology, School of Medicine, National Yang-Ming University, Taipei 112, Taiwan, China
Chia-Yuen Chen, Wing P Chan, Department of Radiology, Taipei Medical University-Municipal Wan Fang Hospital, Taipei 116, Taiwan, China; Department of Radiology, School of Medicine, Taipei Medical University, Taipei 116, Taiwan, China
Author contributions: Tseng HS and Chen CY designed the research; Tseng HS performed the research; Tseng HS, Chiang JH and Chen CY contributed literature reviews; Tseng HS wrote the manuscript; Chen CY and Chan WP analyzed the data and edited the manuscript.
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.
Telephone: +886-2-29307930 Fax: +886-2-29316809
Received: September 14, 2009
Revised: October 28, 2009
Accepted: November 4, 2009
Published online: December 21, 2009

AIM: To assess the safety, yield and clinical utility of percutaneous transgastric computed tomography (CT)-guided biopsy of pancreatic tumor using large needles, in selected patients.

METHODS: We 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. The needle passed through the liver in one case (3%). Nine passes (26%) were made through the stomach. These nine transgastric biopsies which used a coaxial technique (i.e. a 17-gauge coaxial introducer needle and an 18-gauge biopsy needle) were the basis of this study. Immediate and late follow-up CT images to detect complications were obtained.

RESULTS: Tumor tissues were obtained in nine pancreatic biopsies, and histologic specimens for diagnosis were obtained in all cases. One patient, who had a rare sarcomatoid carcinoma, received a second biopsy. One patient had a complication of transient pneumoperitoneum but no subjective complaints. 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 our patients.

CONCLUSION: Pancreatic biopsy can be obtained by a transgastric route using a large needle as an alternative method, without complications of peritonitis or bleeding.

Keywords: Biopsy, Computed tomography, Pancreas, Stomach