Endoscopic ultrasound-guided fine needle biopsy analysis of pancreatic lesions at Rizgari Teaching Hospital in Erbil City

Abstract

Background and objectives: Pancreatic cancer carries a poor prognosis because of delayed diagnosis; early detection and accurate staging are therefore essential for appropriate management. Endoscopic ultrasound-guided fine-needle biopsy (EUS-guided FNB) has demonstrated good diagnostic performance for the detection and differentiation of pancreatic lesions. This study aimed to analyze the usefulness of EUS-guided FNB for the evaluation of pancreatic lesions.

Methods: This prospective cohort study was conducted at the Hawler Gastroenterology and Hepatology Center of Rizgari Teaching Hospital, Erbil, Kurdistan Region, Iraq, from 1 May 2025 to 1 May 2026, on 142 patients with pancreatic lesions detected on imaging. Endoscopic ultrasound characteristics of the lesions and their final histopathological diagnoses were collected. Data were analyzed using SPSS version 27.0, and a P-value of ≤ 0.05 was considered statistically significant.

Results: The median age of the patients was 59 years and most were male (64.1%). Abdominal pain was the most common presentation (91.5%), followed by weight loss (66.9%). On endoscopic ultrasound, most lesions were located in the head of the gland (69.7%), had an irregular border (64.8%) and were hypoechoic (64.1%); a dilated pancreatic duct (≥ 5 mm) was observed in 52.8%. A histopathological diagnosis of pancreatic ductal adenocarcinoma was made in 83 (58.5%) of the lesions sampled by EUS-guided FNB.

Conclusion: EUS-guided FNB of pancreatic lesions contributed to the differentiation and initial histopathological diagnosis of various pancreatic pathologies. Several clinical characteristics and endoscopic ultrasound imaging features were significantly associated with the prevalence of pancreatic ductal adenocarcinoma.