Preoperative endoscopic ultrasound-guided biopsy for resectable pancreatic head tumors increases operative time but not complications - a single center cohort study

Background: Endoscopic ultrasound-guided aspiration or biopsy allows preoperative confirmation of malignancy but is not necessary for resectable pancreatic cancer. Preoperative biopsy may induce pancreatitis, making surgery difficult and complex. Therefore, we performed a retrospective study to evaluate the association between preoperative endoscopic ultrasound-guided biopsy and surgical outcomes in patients with resectable pancreatic head tumors. Materials and Methods: A prospectively enrolled cohort from a single high-volume pancreatic center was analyzed. Between 2007 and 2019, a total of 518 patients with resectable pancreatic head tumors underwent pancreaticoduodenectomy. This analysis was performed to determine the association of preoperative endoscopic ultrasound-guided biopsy with operating time and major complications. Results: In 518 patients who received pancreaticoduodenectomy, 164 patients (31.6%) underwent preoperative endoscopic ultrasound-guided biopsy. Endoscopic ultrasound-guided biopsy increased surgical time (46.9 min, confidence interval: 25.1–68.8, P -value <0.05) without increasing complications (odds ratio: 0.53, confidence interval: 0.31–1.29, P -value=0.29). Conclusion: Preoperative endoscopic ultrasound-guided biopsy for pancreatic head tumors may increase operative time but is not associated with an increased risk of mortality and complications.