| Summary: | Purpose To evaluate the safety and efficacy of ultrasound-guided percutaneous core needle
biopsy (USPCB) of pancreatic and peripancreatic lesions adjacent to critical vessels.
Materials and Methods Data were collected retrospectively from 162 patients who underwent
USPCB of the pancreas (n = 98), the peripancreatic area adjacent to the portal vein, the paraaortic
area adjacent to pancreatic uncinate (n = 34), and lesions on the third duodenal portion
(n = 30) during a 10-year period. An automated biopsy gun with an 18-gauge needle was used
for biopsies under US guidance. The USPCB results were compared with those of the final follow-
up imaging performed postoperatively. The diagnostic accuracy and major complication
rate of the USPCB were calculated. Multiple factors were evaluated for the prediction of successful
biopsies using univariate and multivariate analyses.
Results The histopathologic diagnosis from USPCB was correct in 149 (92%) patients. The major
complication rate was 3%. Four cases of mesenteric hematomas and one intramural hematoma
of the duodenum occurred during the study period. The following factors were significantly associated
with successful biopsies: a transmesenteric biopsy route rather than a transgastric or
transenteric route; good visualization of targets; and evaluation of the entire US pathway. In addition,
the number of biopsies required was less when the biopsy was successful.
Conclusion USPCB demonstrated high diagnostic accuracy and a low complication rate for the
histopathologic diagnosis of pancreatic and peripancreatic lesions adjacent to critical vessels.
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