The Efficacy of Combined Endoscopic Ultrasound Fine-needle Aspiration and Endoscopic Retrograde Cholangiopancreatography in Same Session for the Diagnosis and Management of Pancreatic Carcinoma with Obstructive Jaundice

Objective To explore the application value of endoscopic ultrasound fine-needle aspiration (EUS-FNA) and endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis and treatment ofpatients with pancreatic cancer combined with obstructive jaundice.

Methods Clinical data of patients hospitalized in the Department of Gastroenterology of Peking Union Medical College Hospital who underwent ERCP biliary stent drainage for pancreatic cancer combined with obstructive jaundice from January 1, 2023 to February 26, 2024 were retrospectively collected. They were categorized into the fusion technology group and the simple ERCP group according to whether EUS-FNA was performed in the same endoscopic unit. The differences in pathologic diagnosis rate, ERCP drainage success rate, postoperative complication rate and patients' single hospitalization time were compared between the two groups.

Results A total of 161 patients with pancreatic cancer combined with obstructive jaundice who underwent ERCP biliary stent drainage meeting the inclusion and exclusion criteria were enrolled, of which 80 were in the fusion technique group and 81 were in the simple ERCP group. The pathological diagnosis rate in the fusion technique group was higher than that in the simple ERCP group92.50%(74/80) vs. 46.15%(12/26), P < 0.001, and the ERCP drainage success rate82.50%(66/80) vs. 86.42%(70/81), P=0.360, the overall postoperative complication rate5.00%(4/80) vs. 2.47%(2/81), P=0.443, and single hospitalization time4 (4, 7)d vs. 5 (3, 9)d, P=0.397 were not statistically different from simple ERCP groups.

Conclusion The fusion of EUS-FNA and ERCP enhances the efficiency of diagnosis and treatment for pancreatic carcinoma, warranting widespread adoption and further research.