Push vs pull method for endoscopic ultrasound-guided fine needle aspiration of pancreatic head lesions: Propensity score matching analysis

doi:10.3748/wjg.v24.i27.3006

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 24, Issue 27

This Article

Peer-Review Report of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (8661)

All Articles published online

The chart showing PDF series, WORD series, HTML series, Figures (1-2) series, Tables (1-4) series.

Item

Count

PDF

462

WORD

323

HTML

3595

Figures (1-2)

567

Tables (1-4)

546

Sum=5493

Publishing Process of This Article

The chart showing Browse series, Download series.

Item

Count

Browse

1041

Download

2126

Sum=3167

Jul 21, 2018 (publication date) through Mar 4, 2026

Times Cited of This Article

Times Cited (1)

Journal Information of This Article

Publication Name

World Journal of Gastroenterology

ISSN

1007-9327

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

- Full Article with Cover (PDF)
- Full Article (XML)

Retrospective Study

World J Gastroenterol. Jul 21, 2018; 24(27): 3006-3012
Published online Jul 21, 2018. doi: 10.3748/wjg.v24.i27.3006

Push vs pull method for endoscopic ultrasound-guided fine needle aspiration of pancreatic head lesions: Propensity score matching analysis

Mitsuru Sugimoto, Tadayuki Takagi, Rei Suzuki, Naoki Konno, Hiroyuki Asama, Yuki Sato, Hiroki Irie, Ko Watanabe, Jun Nakamura, Hitomi Kikuchi, Yuichi Waragai, Mika Takasumi, Minami Hashimoto, Yuko Hashimoto, Takuto Hikichi, Hiromasa Ohira

Ko Watanabe, Jun Nakamura, Hitomi Kikuchi, Minami Hashimoto, Takuto Hikichi, Department of Endoscopy, Fukushima Medical University Hospital, Fukushima 960-1247, Japan

Yuko Hashimoto, Department of Diagnostic Pathology, Fukushima Medical University, Fukushima 960-1247, Japan

Author contributions: Sugimoto M designed and performed the study; Sugimoto M, Takagi T and Ohira H analyzed the data and wrote the paper; Suzuki R, Konno N, Asama H, Sato Y, Irie H, Watanabe K, Nakamura J, Kikuchi H, Waragai Y, Takasumi M, Hashimoto M and Hikichi T provided clinical advice; Hashimoto Y performed pathological diagnoses; and Hikichi T and Ohira H supervised the study.

Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Fukushima Medical University.

Informed consent statement: Patients were not required to give informed consent for participation in the study because the analysis used anonymous clinical data obtained after each patient provided written consent agreeing to treatment. For full disclosure, the details of the study are published on the home page of Fukushima Medical University.

Conflict-of-interest statement: We have no financial relationships to disclose.

Data sharing statement: No additional data are available.

Correspondence to: Tadayuki Takagi, MD, PhD, Associate Professor, Department of Gastroenterology, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima Prefecture 960-1247, Japan. daccho@fmu.ac.jp

Telephone: +81-24-5471202 Fax: +81-24-5472055

Received: May 2, 2018
Peer-review started: May 4, 2018
First decision: May 17, 2018
Revised: June 5, 2018
Accepted: June 25, 2018
Article in press: June 25, 2018
Published online: July 21, 2018
Processing time: 77 Days and 17.1 Hours

Abstract

AIM

To evaluate the efficacy of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of pancreatic head cancer when pushing (push method) or pulling the echoendoscope (pull method).

METHODS

Overall, 566 pancreatic cancer patients had their first EUS-FNA between February 2001 and December 2017. Among them, 201 who underwent EUS-FNA for pancreatic head lesions were included in this study. EUS-FNA was performed by the push method in 85 patients, the pull method in 101 patients and both the push and pull methods in 15 patients. After propensity score matching (age, sex, tumor diameter, and FNA needle), 85 patients each were stratified into the push and pull groups. Patient characteristics and EUS-FNA-related factors were compared between the two groups.

RESULTS

Patient characteristics were not significantly different between the two groups. The distance to lesion was significantly longer in the push group than in the pull group (13.9 ± 4.9 mm vs 7.0 ± 4.9 mm, P < 0.01). The push method was a significant factor influencing the distance to lesion (≥ median 10 mm) (P < 0.01). Additionally, tumor diameter ≥ 25 mm (OR = 1.91, 95%CI: 1.02-3.58, P = 0.043) and the push method (OR = 1.91, 95%CI: 1.03-3.55, P = 0.04) were significant factors contributing to the histological diagnosis of malignancy.

CONCLUSION

The pull method shortened the distance between the endoscope and the lesion and facilitated EUS-FNA of pancreatic head cancer. The push method contributed to the histological diagnosis of pancreatic head cancer using EUS-FNA specimens.

Keywords: Endoscopic ultrasound-guided fine needle aspiration; Pancreatic head; Pancreatic cancer; Push method; Pull method

Core tip: Solid pancreatic head lesions are punctured by the push or pull method. We evaluated the efficacy of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) using the push and pull methods for pancreatic head cancer. After propensity score matching (age, sex, tumor diameter, and FNA needle), 85 patients each were stratified into the push and pull groups. Patient characteristics and EUS-FNA-related factors were compared between the two groups. The pull method shortened the distance between the endoscope and the lesion and facilitated EUS-FNA of pancreatic head cancer. The push method contributed to the histological diagnosis of pancreatic head cancer using EUS-FNA specimens.