22-gauge Co-Cr versus stainless-steel Franseen needles for endoscopic ultrasound-guided tissue acquisition in patients with solid pancreatic lesions

Background/Aims: Endoscopic ultrasound -guided tissue acquisition (EUS-TA) using Franseen needles is reportedly useful for its high diagnostic yield. This study compared the diagnostic yield and puncturing ability of EUS-TA using 22 -gauge cobalt -chromium (COCr) needles with those of stainless -steel Franseen needles in patients with solid pancreatic lesions. Methods: Outcomes were compared between the 22 -gauge Co-Cr Franseen needle (December 2019 to November 2020; group C) and stainless -steel needle (November 2020 to May 2022; group S). Results: A total of 155 patients (group C, 75; group S, 80) were eligible. The diagnostic accuracy was 92.0% in group C and 96.3% in group S with no significant intergroup differences (p=0.32). The rate of change in the operator (from training fellows to experts) was 20.0% (15/75) in group C and 7.5% (6/80) in group S. Stainless -steel Franseen needles showed less inter -operator difference than CoCr needles (p=0.03). Conclusions: Both Co-Cr and stainless -steel Franseen needles showed high diagnostic ability. Stainless -steel Franseen needles are soft and flexible; therefore, the range of puncture angles can be widely adjusted, making them suitable for training fellows to complete the procedure.