The Diagnostic Yield of Fine Needle Aspiration and Biopsy Needles According to Needle Passes Number in Diagnosing Pancreatic Adenocarcinoma

Introduction Endoscopic ultrasound guided fine needle aspiration/biopsy (EUS‐FNA/FNB) is the main diagnostic tool for solid pancreatic lesions. However, it is associated with a limited diagnostic yield. Aim We aimed to assess the optimal needle passes number of FNA needles to achieve maximum diagnostic yield. Methods We performed a retrospective study including all patients who were diagnosed with pancreatic adenocarcinoma by EUS‐FNA/FNB. The diagnostic yield was reported for all needles according to the number of needle passes. Results Overall, 227 patients underwent EUS‐FNA/FNB. FNBs in 85 patients (37.4%), and FNA in 142 patients (62.5%). The needle number passes in the FNB was 1.46 ± 0.70 versus 2.11 ± 1.12 in the FNA group ( p < 0.0001). One, two, and three needle passes yielded a diagnosis rate of malignancy in 76.8%, 68.4% and 70% of cases respectively for histology, while for cytology, the yield was 78.6%, 89.4% and 100%, respectively. For FNB needle types, the acquire needle outperformed the other needle, as the histological yield for one pass was 78.6%, 80% for two passes, and 57.1% for three passes, while for cytology, the yield was 79.3%, 90%, and 100% for one, two and three passes, respectively. For the FNA needle, the cytological yield was 88.7% for one pass, and higher for two and three passes. Conclusion The number of needle passes for FNB (maximum three passes) was lower than FNA needles (3–4 passes) to obtain an optimal diagnostic yield.