Sugimoto M, Takagi T, Suzuki R, Konno N, Asama H, Sato Y, Irie H, Watanabe K, Nakamura J, Kikuchi H, Waragai Y, Takasumi M, Hashimoto M, Hashimoto Y, Hikichi T, Ohira H. Push vs pull method for endoscopic ultrasound-guided fine needle aspiration of pancreatic head lesions: Propensity score matching analysis. World J Gastroenterol 2018; 24(27): 3006-3012 [PMID: 30038467 DOI: 10.3748/wjg.v24.i27.3006]
Corresponding Author of This Article
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
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
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World J Gastroenterol. Jul 21, 2018; 24(27): 3006-3012 Published online Jul 21, 2018. doi: 10.3748/wjg.v24.i27.3006
Table 1 Comparison of patient characteristics and endoscopic ultrasound-guided fine needle aspiration results
Push group (n = 85)
Pull group (n = 85)
P value
Patient characteristics
Age (yr), mean ± SD
67.1 ± 10.2
67.6 ± 9.7
0.77
Sex (male/female)
48/37
46/39
0.88
Tumor diameter (mm), mean ± SD
25.9 ± 10.3
26.6 ± 10.1
0.67
EUS-FNA results
Distance to lesion
13.9 ± 4.9
7.0 ± 4.9
< 0.01
No. of needle passes of pancreas, mean ± SD
2.4 ± 1.3
2.4 ± 1.3
0.86
Needle gauge
0.57
19
2
1
22
32
38
25
51
46
Diagnosis of malignancy by cytology, n (%)
78 (91.8)
78 (91.8)
1
Diagnosis of malignancy by histology, n (%)
47 (55.3)
34 (40.0)
0.065
Overall diagnosis of malignancy, n (%)
80 (94.1)
80 (94.1)
1
Adverse events
Abscess around pancreas, n (%)
0 (0)
1 (1.2)
1
Table 2 Factors influencing the distance to lesion n (%)
Distance to lesion < 10 mm (n = 70)
Distance to lesion ≥ 10 mm (n = 100)
P value
Age ≥ 68 yr
32 (45.7)
56 (56.0)
0.21
Sex, male
35 (50.0)
59 (59.0)
0.28
Tumor diameter ≥ 25 mm
27 (38.6)
45 (45.0)
0.43
Push method
12 (17.1)
73 (73.0)
< 0.01
Needle gauge, 19 or 22 G
32 (45.7)
41 (41.0)
0.64
Table 3 Factors contributing to the diagnosis of malignancy by histology (univariate analysis) n (%)
Malignancy by histology(-) (n = 89)
Malignancy by histology(+) (n = 81)
P value
Age ≥ 68 yr
50 (56.2)
38 (46.9)
0.28
Sex, male
50 (56.2)
44 (54.3)
0.88
Tumor diameter ≥ 25 mm
45 (50.6)
53 (65.4)
0.062
Push method
38 (42.7)
47 (58.0)
0.065
Needle gauge, 19 or 22 G
37 (41.6)
36 (44.4)
0.76
Needle passes ≥ 2
71 (80.0)
59 (72.8)
0.37
Table 4 Factors contributing to the diagnosis of malignancy by histology (multivariate analysis)
OR
95%CI
P value
Tumor diameter ≥ 25 mm
1.91
1.02-3.58
0.043
Push method
1.91
1.03-3.55
0.040
Citation: Sugimoto M, Takagi T, Suzuki R, Konno N, Asama H, Sato Y, Irie H, Watanabe K, Nakamura J, Kikuchi H, Waragai Y, Takasumi M, Hashimoto M, Hashimoto Y, Hikichi T, Ohira H. Push vs pull method for endoscopic ultrasound-guided fine needle aspiration of pancreatic head lesions: Propensity score matching analysis. World J Gastroenterol 2018; 24(27): 3006-3012