Learning, techniques, and complications of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Guideline

TLDR

The ESGE Technical Guideline complements the earlier Clinical Guideline on EUS‑guided sampling outcomes and patient‑management implications, targeting endoscopists. It aims to address learning curves, technical aspects, complications, and specimen processing for EUS‑guided sampling. It reviews technical strategies—such as rapid on‑site evaluation, optimal needle size, microcore isolation, and adequate pass numbers—to maximize diagnostic yield across solid and cystic pancreatic lesions, submucosal tumors, and lymph nodes. The guideline includes a concise two‑page executive summary of evidence statements and recommendations.

Abstract

This article is the second of a two-part publication that expresses the current view of the European Society of Gastrointestinal Endoscopy (ESGE) about endoscopic ultrasound (EUS)-guided sampling, including EUS-guided fine needle aspiration (EUS-FNA) and EUS-guided Trucut biopsy. The first part (the Clinical Guideline) focused on the results obtained with EUS-guided sampling, and the role of this technique in patient management, and made recommendations on circumstances that warrant its use. The current Technical Guideline discusses issues related to learning, techniques, and complications of EUS-guided sampling, and to processing of specimens. Technical issues related to maximizing the diagnostic yield (e. g., rapid on-site cytopathological evaluation, needle diameter, microcore isolation for histopathological examination, and adequate number of needle passes) are discussed and recommendations are made for various settings, including solid and cystic pancreatic lesions, submucosal tumors, and lymph nodes. The target readership for the Clinical Guideline mostly includes gastroenterologists, oncologists, internists, and surgeons while the Technical Guideline should be most useful to endoscopists who perform EUS-guided sampling. A two-page executive summary of evidence statements and recommendations is provided.