Investigation of diagnostic efficacy of endoscopic ultrasound in pancreatic lesions retrospectively

Identification and management of pancreatic lesions and some diseases of pancreas have always been an important problem until the last decade. However, due to the technical advances made in endoscopic ultrasonography, great advances have been made in the classification of pancreatic solid and cystic lesions and in the diagnosis and management of many other pancreatic diseases. Endosonography (EUS) is superior in the identification and management of pancreatic lesions compared to all other imaging modalities. In our study, we aimed to investigate the diagnostic efficacy of EUS in pancreatic solid and cystic lesions in a large volume center for EUS retrospectively. In our study, the data of all patients over the age of 18 who applied to the Fırat University Hospital Endoscopy Unit between November 2013 and December 2019 were examined retrospectively. Laboratory data of the patients were obtained from patient data processing records and patient files. After the procedure, 148 (34,4%) of 430 patients had cysts and 282 (65,6%) had solid lesions. 33 (22,3%) of these cysts were mucinous while 115 (77,7%) were non-mucinous cysts. The cyst CEA levels of the patients with mucinous cysts were found to be significantly higher than the non-mucinosis group (p = 0,008). In the study, a gold standard result was obtained when the results of both FNAB and the patients who were operated were evaluated together. 59 of 62 (95%) patients with benign EUS result were found benign in the gold standard method, and 239 of 296 (80 %) patients with malignant EUS result were found as malignant in the gold standard method. When malignancy was accepted as positive, the sensitivity of EUS was 98,8%, specificity 50,9%, its positive predictive value 80,7%, negative predictive value 95,2%, and its accuracy 83,2%. As a result; EUS is a reliable, invasive method used in the differential diagnosis of pancreatic lesions. Histopathological and biochemical analyzes of the materials taken with the help of FNAB performed with EUS are guiding in the identification of these lesions. In experienced hands, EUS can be used effectively in the management of pancreatic lesions compared to all other methods. Keywords: Endosonography, pancreatic lesions, pancreatic cystic lesions, fine needle aspiration biopsy, pancreatic tumors