Endoscopic Ultrasound Guided with Fine Needle Biopsy
Endoscopic Ultrasound (EUS) with Fine Needle Biopsy (FNB) also known as EUS-FNB is a minimally invasive technique that is used to obtain tissue and fluid from pancreatic and non-pancreatic lesions for diagnostic purposes or to see the progress of a certain treatment. The technique uses a hollow needle guided by an endoscopic ultrasound.
EUS with FNB is usually performed following a detection of a suspected mass in the pancreas through other imaging techniques such as ultrasound, endoscopy, magnetic resonance imaging (MRI), or computed tomography (CT).
What is Fine Needle Biopsy?
Fine Needle Biopsy is a diagnostic procedure whereby a hollow needle is used to obtain tissue and fluid samples to be checked under a microscope for the presence of cancerous cells or other benign conditions affecting the target organ.
What is Endoscopic Ultrasound (EUS)?
EUS is a procedure that involves inserting a thin tube into the mouth, passing it through the stomach and into the upper abdominal organs. The tube has a small ultrasound probe on the tip which emits sound waves that bounce off on the surrounding structures –liver, stomach, pancreas, small intestine, and bile ducts- and then recaptured by the probe which converts them into images. This allows for your doctor to get detailed images of your pancreas since it is located next to the stomach and the small intestine.
The EUS is used for diagnostic purposes and to check the size of the pancreatic tumor as well as the location, spread of the disease, and to take a cells and fluid samples for biopsy.
Preparation for EUS with FNB
Prior to undergoing an Endoscopic Ultrasound (EUS) with Fine Needle Biopsy (FNB), you will be given specific instructions that will help you prepare for this procedure. These pre-operative instructions include, but not limited to:
- The type of medications you need to adjust the intake
- Medication which you may continue or discontinue taking
- When to drink and/or eat
You will also need to disclose to your doctor if you are taking any medication, other than the ones prescribed, and the type as well as the health conditions that you may have or run in your family such as diabetes, high blood pressure or cardiovascular illnesses.
The Procedure
Endoscopic Ultrasound (EUS) with Fine Needle Biopsy (FNB) is an outpatient procedure that is done under sedation, and usually takes about 30 – 90 minutes.
During the procedure, a long thin tube with a camera at the end (endoscope) is inserted through the mouth and passed through the esophagus, stomach, duodenum which is part of the small intestine, liver, and pancreas. The tip of the endoscope consists of a small rotating ultrasound system that can scrutinize about four inches into the surrounding tissue.
The endoscope can also be inserted anally in which case the examination focuses on the rectum and colon.
Once the area of concern has been located, a fine hollow needle is inserted through a canal in the endoscope and inserted into the area that needs to be examined. Tissue and fluid samples are then retrieved. Theses samples are then sent to a pathologist for examination. During the procedure, several samples are normally taken from different parts of the area of concern.
Possible Risks of EUS with FNB
Endoscopic Ultrasound (EUS) with Fine Needle Biopsy (FNB) is considered a generally safe and reliable diagnostic procedure but it may have a few minor complications including:
- Nausea
- Vomiting
- Inflammation of the pancreas
- Bleeding
- Infection
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