To compare the diagnostic performance of different suction techniques during EUS - FNB for pancreatico-biliary lesions

EUS FNB is now being considered the optimal technique for sampling of pancreaticobiliary lesions due to its high accuracy and less adverse complication rates. Currently, to the best of our knowledge, there is no data in India regarding the optimal sampling technique. This is a prospective, randomized controlled trail, with three arms, comparing the diagnostic efficacy of EUS FNB techniques – standard no suction vs stylet slow pull vs wet suction for pancreaticobilary lesion. We aim to include all patients more than 18 years presenting to us with indication of for EUS FNB for pancreaticobilary lesions and giving informed consent, excluding age morethan18, bleeding diathesis and pregnant women. We shall compare the three techniques by taking a biopsy consecutively with each sampling technique, and send each separately labelled sample to the pathologist, who is blinded to the technique of sampling and will report each sample individually and the results will be analysed according to the accuracy provided by the sampling technique and the final diagnosis, along with the tissue integrity and blood contamination. Further treatment will be as per treating physician. Expected outcome will be to compare the non inferiority of wet suction and slow stylet pull technique with the standard no suction technique.