Abstract
PURPOSE: To evaluate the safety and feasibility of computed tomographic (CT)-guided coaxial fine-needle aspiration biopsy (FNAB) of masses in or around the head of the pancreas with a posterior approach that transgresses the inferior vena cava (IVC). MATERIALS AND METHODS: The authors retrospectively reviewed the records of 29 patients with lesions located within (n = 24) or around (n = 5) the pancreatic head who underwent CT-guided FNAB with the posterior transcaval route due to obstruction of the anterior approach by bowel, liver, and/or other structures. A coaxial needle technique was used, with an outer 18-gauge needle positioned posterior to the IVC and an inner 22-gauge needle traversing the IVC to obtain a biopsy of each lesion. All biopsy specimens were subjected to cytologic evaluation. Medical records of all patients were evaluated for complications. RESULTS: All lesions were safely accessed with the posterior transcaval approach without major complications. The biopsies revealed a malignant process in 21 patients, benign pancreatic cysts in two patients, and pancreatitis in one patient. There were five false-negative biopsy results. Minor complications occurred in four patients (small retroperitoneal hematomas occurred in three and abdominal pain occurred in one). CONCLUSION: CT-guided coaxial FNAB by means of a posterior transcaval approach is a safe method for obtaining samples from lesions in or around the pancreatic head.
Original language | English (US) |
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Pages (from-to) | 63-69 |
Number of pages | 7 |
Journal | Radiology |
Volume | 222 |
Issue number | 1 |
DOIs | |
State | Published - 2002 |
Keywords
- Biopsies
- Computed tomography (CT), guidance
- Pancreas, biopsy
- Pancreas, cysts
- Pancreas, neoplasms
- Pancreatitis
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging