الفهرس 
Chapter 1 IntroductionOnly 14 pages are availabe for public view
 |  | from | 136 |  |  |
| | | from | 136 | | |
Abstract
Introduction and aim: Malignant portal vein thrombosis (PVT) is found in up to 44% of patients with HCC. The nature of the thrombus will eventually influence treatment selection. The aim of this study is to assess the feasibility, safety, and efficacy of EUS-FNA in determining the nature of PVT which did not fulfill the malignant criteria via imaging studies in patients with liver cirrhosis and/or HCC. Patients and methods: This is a prospective study conducted on 34 patients with liver cirrhosis and/or HCC with PVT from May 2017 to December 2019. Under EUS guidance, PVT was punctured by a 22G FNA needle (1-2 passes) followed by monitoring of the puncture tract using colour doppler. Patients were followed for adverse events for 2 hours after recovery. Results: Throughout the 30 months study period, 34 patients including 24 males with a mean age of 59±8 years were enrolled. There were 8 patients with known HCC and 26 with no detected liver masses by CT. EUS-FNA from PVT was positive for malignancy in 3 patients (8.8%), from which only 1 patient was diagnosed as HCC by CT and 2 patients were newly diagnosed as HCC after EUS-FNA (from cirrhotic nodule in 1 patient and from small lesion missed by CT in 1 patient). No major complication occurred in any patient. Conclusion: EUS-FNA is safe and effective technique in determining the nature of PVT which did not fulfill the malignant criteria via imaging studies in patients with liver cirrhosis and/or HCC.