Ultrasonografi Kýlavuzluðunda Pankreas Ýðne Biyopsileri

To share the efficacy and success rates of the needle biopsies of pancreatic masses performed with various needle types under ultrasonography guidance in our department forms the purpose of our study. One hundred ultrasonography guided needle biopsies with various needle types of 18-22 G in size were applied to the patients with pancreatic masses betvveen 1993 May and 2005April. Mean age of the patients was 55.5 ± 12.0 years and woman/man ratio was 0.46. The pathological diagnosis was obtained from 82 patients. Tumor localizations were pancreatic head for 73%, corpus for 13%, tail for 9%, corpus-tail for 5% of the patients. Biopsies performed with computed tomography guided were excluded from the series. Needles used for 82 pancreatic biopsies were West-Cott 20 G in 65 cases, Sonopsy 21 G in 8 cases, Trucut 18 G in 7 cases, and VVest-Cott 22 G in two cases. The rates of accuracy were found 74.0%, 63.0%, 71.4%, and 50%, respectively. The sensitivity, specificity, and accu-racy rates were 70%, 100%, and 72.0%, respectively. No significant difference in accuracy was observed betvveen needles, and pancreatic localizations (p> 0.05). Ýn addition, success rates of cystic and soiid lesions were not different statistically (p= 0.05). No majör complication was observed. Ultrasonography guided needle biopsy is a useful method for diagnosis and management of pancreatic masses. The relationship betvveen pancreas and the adjacent main vascular structures should be considered befo-re the biopsy. If it is thought to be a saf e procedure, ultrasonography guided biopsy or computed tomography guided biopsy, if needed, for obese patients with too much abdominal air can be performed. Endoscopic ultrasonography guided biopsy is nee-ded for the patients with small pancreatic masses or vvhose diagnoses are not provided with repeated biopsies.

Ultrasonography Guided Pancreatic Needle Biopsies

Bu çalýþmanýn amacýný pankreas kitlelerine ultrasonografi kýlavuzluðunda kliniðimizde yapmýþ olduðumuz iðne biyopsilerinin etkinliðini ve çeþitli tipteki biyopsi iðnelerinin baþarý oranlarýný paylaþmak oluþturmaktadýr. Mayýs 1993-Nisan 2005 tarihleri arasýnda, 18-22 G çaplý çeþitli tipteki iðneler ile 114 pankreas kitlesi olan hastaya, ultrasonografi eþliðinde iðne biyopsisi yapýldý. Olgularýn yaþ ortalamasý 55.5 ± 12.0 ve kadýn/erkek oraný 0.46 idi. Bu olgulardan, patolojik taný elde edilen 82 olgu deðerlendirildi. Bu olgularýn %73 (61)’ü pankreas baþý, %13 (10)’ü gövdesi, %9 (7)'u kuyruðu ve %5 (4)’i gövde-kuyruk yerleþimliydi. Bilgisayarlý tomografi eþliðinde biyopsi yapýlan hastalar deðerlendirmeye alýnmamýþtýr. Pankreas kitlelerine yönelik yapýlan 82 biyopsinin; 65’inde West-Cott 20 G, sekizinde Sonopsy 21 G, yedisinde Trucut 18 G ve ikisinde West-Cott 22 G iðne kullanýldý. Doðru tanýya götürme oranlarý sýrasýyla, %74.0, %63.0, %71.4 ve %50 bulundu. Bütün biyopsilerde ise duyarlýlýk %70, özgüllük %100, doðruluk %72.0 olarak belirlendi. Hem iðneler arasýnda, hem de pankreastaki yerleþimine göre, doðruluk oranlarý açýsýndan anlamlý bir fark saptanmadý (p> 0.05). Kistik-solid lezyonlar arasýnda da, baþarý oranlarý açýsýndan belirgin fark saptanmadý (p= 0.05). Hastalarda majör bir komplikasyon izlenmedi. Pankreas kitlelerinde taný koyabilmek ve tedaviyi yönlendirmek amacý ile ultrasonografi kýlavuzluðunda yapýlan iðne biyopsileri, tanýya yardýmcý bir yöntemdir. Pankreasýn ana vasküler yapýlara olan komþuluðu dikkate alýnmalý, vasküler yapýlara zarar verilmeyeceðinden emin olunursa öncelikle ultrasonografi, aþýrý kilolu hastalarda ise bilgisayarlý tomografi kýlavuzluðunda biyopsi yapýlabilir. Tekrar biyopside de sonuç alýnamayan olgularda ve küçük pankreas lezyonlarýnda ise endoskopik ultrasonografi kýlavuzluðunda biyopsi yapýlmasý gereklidir.