ESGE guidelines: update on endoscopic ultrasound-guided sampling

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  • The European Society of Gastrointestinal Endoscopy (ESGE) offers an updated guideline for endoscopic ultrasound (EUS)-guided sampling in gastroenterology, representing evidence-based consensus on best practices as of early 2017.
  • The committee cautions that all decisions require consideration of clinical context and resource availability.


  • EUS-guided sample recommended for pancreatic solid lesions as first-line procedure (strong recommendation).
  • With inconclusive/negative results but high degree of suspicion, recommendation is reevaluation of pathology slides, repeat sampling, or surgery (weak recommendation).
  • With pancreatitis and pancreatic mass, negative sampling results require cautious interpretation (strong recommendation).
  • For esophageal cancer, use EUS-guided sample for lymph node assessment (T1, maybe T2 adenocarcinoma), possible metastatic lesions (eg, liver) (weak recommendation).
  • EUS-guided sampling recommended for solid liver masses. 
  • EUS-guided sampling recommended for lymphadenopathy of unknown origin if outcomes would guide patient management and no superficial sites accessible.
Study design
  • Separate task forces addressed key questions under different subject headings.