Prospective analysis of the utility of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in pancreatic masses, using a 22-gaude or 25-gauge needle

Background: Endoscopic ultrasound guided fine needle aspiration (EUS-FNA) is widely performed to diagnose pancreatic masses. Recently 25-gauge needle (25G) is available, which is thinner and more flexible than 22-gauge needle (22G) for EUS-FNA. Smaller needle, like a 25G might provide less bloody component, less complications and more safe and easier to maneuver than using larger needle. The aim of this study was to compare efficacy of 25G with 22G in EUS-FNA for pancreatic tumor. Method: From April 2009 to April 2010, at Samsung Medical Center (Seoul, South Korea), we randomized the patients who needed EUS-FNA for pancreatic tumor into 25G or 22G group and performed the procedure using each needle. We enrolled the patients with all of pancreas mass like solid, cyst and mixed type. Diagnostic accuracy and complication were analyzed prospectively in both 22G and 25G group. Results: A total of 207 patients prospectively were enrolled in EUS-FNA for patients with a pancreatic tumor. There were 105 patients in the 22G group and 102 patients in the 25G group. Overall accuracy for 22G and 25G was 91.4% (96/105) and 85.3% (87/102), respectively (p=0.306). In 22G group, post-FNA pancreatitis occurred more frequently than 25G needle group (p=0.119). Conclusions: A 25G can be used as efficiently as a 22G in EUS-FNA for patients with a pancreatic tumor.