Endoscopic ultrasound is an important innovation in the field of gastrointestinal endoscopy and allows evaluation of many organs in the vicinity of the gastrointestinal tract. Endoscopic ultrasound-fine needle aspiration has been established to be an important tool in the management of pancreaticobiliary disease and is used for screening, staging, biopsy confirmation, and palliation. The accuracy of endoscopic ultrasound-fine needle aspiration is affected by several factors such as different needle sizes and types and fine needle aspiration techniques. Several comparative studies have been published on various techniques, such as the use of a stylet and suction during fine needle aspiration. Although most studies demonstrate high accuracy across techniques and equipment, various fine needle biopsy histology needles have been studied to compare the advantage of fine needle biopsy over fine needle aspiration. Although fine needle biopsy needles provide better tissue architecture and require fewer numbers of passes, there is no significant evidence of the superiority of fine needle biopsy over fine needle aspiration with regard to diagnostic yield and core tissue procurement. The main aim of this article is to review the various methodologies for improving the practice of endoscopic ultrasound-fine needle aspiration and endoscopic ultrasound- fine needle biopsy tissue sampling for cytological and histological analysis.
Pujan Kandel, Michael B Wallace