Present situation of EUS-FNAB in our institute and future appropriate direction of this procedure in Japan

We describe the present view of performing diagnostic endoscopic ultrasonography guided fine needle aspiration biopsy (EUS-FNAB). In the pancreatic diseases, our application of EUS-FNAB for pancreatic disease has been as follows: as to the operable cases, EUS-FNAB should not be performed through any pathway penetrating the duodenum and the stomach. EUS-FNAB is contraindicated in cystic diseases. As to the cases diagnosed as inoperable with various imaging modalities, EUS-FNAB should be performed to obtain the pathological evidence. In gastrointestinal disorders, all intramural diseases are appropriate indications for this procedure. Even if the target lesion is in the far oral part of the large intestine, we perform EUS-FNAB by the special method described in this paper. Lymphadenopathy for appropriate cases is one of the best cases in which to perform EUS-FNAB. Mediastinal lymph node metastasis influences the treatment plan of lung cancer; the application of this treatment is increasing in our institute.