Heparin-based Wet Suction Method in EUS Fine Needle Biopsy of Solid Pancreatic Mass
- Conditions
- Endoscopic UltrasonographyEUS-FNAPancreatic Neoplasms
- Interventions
- Procedure: EUS fine needle biopsy with heparin wet suction
- Registration Number
- NCT04707560
- Lead Sponsor
- National Cheng-Kung University Hospital
- Brief Summary
The objective of this randomized cross-over trial is to evaluate whether Heparin based wet suction technique, compared with dry suction technique, shall present a higher quality tissue core by using quantitative macroscopic and microscopic scale.
- Detailed Description
Background \& aim Endoscopic ultrasound guided fine needle biopsy (EUS-FNB) is the main tool for tissue acquisition and pathological diagnosis of pancreatic solid mass because of its superior accuracy and lower complication rate compared to CT-guided biopsy. However, the tissue adequacy and diagnostic yield remained unsatisfactory for 2 reasons. First, the conventional dry suction technique (DST) often get small tissue and 3 or more needle passes (i.e. biopsies) are required to obtain enough specimen. Second, blood contamination of the acquired tissue interfered with microscopic examination. Investigator aim to develop a novel technique to improve tissue acquisition within a fewer needle passes and avoid blood contamination by using heparin-based modified wet suction (H-MWST).
Methods This study will be a randomized crossover clinical trial. Patients with pancreatic solid mass indicated for EUS FNB will be enrolled. EUS FNB will be done by one experienced endoscopists in National Cheng Kung University Hospital. Patients will be randomized in a 1:1 ratio to receive EUS FNB with either dry suction technique (DST) or H-MWST first for the initial 2 needle passes, and then crossover to another suction technique for a total of 4 needle passes. The obtained tissue of each needle pass will be sent separately and examined by a pathologist who is unaware of the procedure order. Procedure related complications will be recorded. The primary outcome will be the acquired tissue quality quantified comparison. The secondary outcome will be the overall diagnostic yield, the specimen adequacy, and complication rate by each suction technique.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 50
- Patients had pancreatic solid mass on CT scan or abdominal echo image
- Anti-platelet and anticoagulant user who cannot stop the medication
- Recent acute pancreatitis episode (within 2 weeks)
- Patient with severe cardio-pulmonary dysfunction
- Pregnant women and adolescent < 20 years old
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- CROSSOVER
- Arm && Interventions
Group Intervention Description Heparin Wet first group EUS fine needle biopsy with heparin wet suction Heparin based wet suction method of EUS FNB will go first for 2 passes and then shift to dry suction method for another 2 passes. Dry suction first group EUS fine needle biopsy with heparin wet suction Dry suction method of EUS FNB will go first for 2 passes and then shift to heparin base wet suction method for another 2 passes.
- Primary Outcome Measures
Name Time Method Quantification of tissue quality 48 weeks White tissue core length will be assessed immediately after procedure. The acquired tumor tissue area and contaminant blood clot percentage will be assessed after total recruitment by single pathologist
- Secondary Outcome Measures
Name Time Method Needle pass number needed to establish diagnosis 48 weeks After 5 working days of histology slide preparation and pathologist interpretation. Investigator can get the result
Diagnostic performance between different suction method 48 weeks After 5 working days of histology slide preparation and pathologist interpretation. Investigator can get the result
Trial Locations
- Locations (1)
National Cheng Kung University Hospital
🇨🇳Tainan, Taiwan