{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:58Z","timestamp":1789948858193,"version":"4.0.1"},"reference-count":25,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T00:00:00Z","timestamp":1789862400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T00:00:00Z","timestamp":1789862400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"abstract":"ABSTRACT<\/jats:title>\n \n Background and Aim<\/jats:title>\n The heparin wet suction technique (HWST) may improve tissue quality in endoscopic ultrasound\u2013guided fine\u2010needle biopsy (EUS\u2010FNB) by preventing blood clot formation within the needle. We compared the diagnostic performance and safety of HWST with the conventional suction technique (CST), using a novel 22\u2010gauge FNB needle in patients with solid pancreatic masses.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n In this multicenter, single\u2010blinded, randomized crossover trial, patients with solid pancreatic masses (\u2265\u20091\u2009cm) were randomized 1:1 to HWST\u2010first or CST\u2010first. Each patient underwent one pass with each technique using the novel 22\u2010gauge needle. The primary outcome was diagnostic yield; secondary outcomes included technical success, adverse events, and adequacy for immunohistochemistry (IHC).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 174 randomized patients, 170 received both interventions and were analyzed; baseline characteristics were comparable. The diagnostic yield was 82.9% (95% confidence interval [CI], 76.6\u201387.9) with HWST and 83.5% (95% CI, 77.2\u201388.4) with CST. The paired difference was \u22120.6 percentage points (95% CI, \u22126.7 to 5.5; exact McNemar\n p<\/jats:italic>\n \u2009=\u20091.000). The combined diagnostic yield after sequential sampling was 91.2% (95% CI, 86.0\u201394.6). Technical success was 100% with both techniques, and IHC adequacy was similar (HWST: 80.6% vs. CST: 78.8%). One self\u2010limiting bleeding event occurred during CST.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n HWST showed diagnostic yield, technical success, and safety comparable to CST. Both techniques are highly effective for EUS\u2010FNB of solid pancreatic masses. Sequential sampling may improve overall diagnostic yield, although this finding should be interpreted cautiously and requires further validation.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jgh.70759","type":"journal-article","created":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T23:20:17Z","timestamp":1789946417000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Heparin Wet Suction Versus Conventional Suction in Endoscopic Ultrasound\u2013Guided Fine\u2010Needle Biopsy for Solid Pancreatic Masses: A Multicenter Randomized Crossover Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6068-3849","authenticated-orcid":false,"given":"Hyung Ku","family":"Chon","sequence":"first","affiliation":[{"name":"Division of Biliopancreas, Department of Internal Medicine Wonkwang University College of Medicine, Institute of Wonkwang Medical Science Iksan Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6642-6635","authenticated-orcid":false,"given":"Dong Kee","family":"Jang","sequence":"additional","affiliation":[{"name":"Department of Medicine Samsung Medical Center, Sungkyunkwan University School of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8708-3280","authenticated-orcid":false,"given":"Woo Hyun","family":"Paik","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Liver Research Institute Seoul National University Hospital, Seoul National University College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7592-8060","authenticated-orcid":false,"given":"Seong\u2010Hun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Research Institute of Clinical Medicine of Jeonbuk National University Biomedical Research Institute of Jeonbuk National University Hospital Jeonju Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6084-0138","authenticated-orcid":false,"given":"Dongwook","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Asan Medical Center, University of Ulsan College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5931-4643","authenticated-orcid":false,"given":"Eunae","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Chonnam National University Medical School and Hospital Gwangju Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1603-7468","authenticated-orcid":false,"given":"Se Woo","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine Hwaseong\u2010si Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0634-5141","authenticated-orcid":false,"given":"Jung Wan","family":"Choe","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine Korea University Ansan Hospital, Korea University College of Medicine Ansan Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5573-7083","authenticated-orcid":false,"given":"Eui Joo","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine Gachon University Gil Medical Center, Gachon University College of Medicine Incheon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0256-9781","authenticated-orcid":false,"given":"Sung Yong","family":"Han","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Internal Medicine and Biomedical Research Institute Pusan National University Hospital and School of Medicine, Pusan National University Busan Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4174-0091","authenticated-orcid":false,"given":"Jae Hee","family":"Cho","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine Gangnam Severance Hospital, Yonsei University College of Medicine Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2174-9726","authenticated-orcid":false,"given":"Sang Hyub","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Liver Research Institute Seoul National University Hospital, Seoul National University College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,20]]},"reference":[{"issue":"10","key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1055\/s-0043-119219","article-title":"Technical Aspects of Endoscopic Ultrasound (EUS)\u2010Guided Sampling in Gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Guideline \u2010 March 2017","volume":"49","author":"Polkowski M.","year":"2017","journal-title":"Endoscopy"},{"issue":"2","key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"161","DOI":"10.5946\/ce.2021.069","article-title":"Clinical and Technical Guideline for Endoscopic Ultrasound (EUS)\u2010Guided Tissue Acquisition of Pancreatic 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Y.","year":"2016","journal-title":"World Journal of Gastroenterology"},{"issue":"11","key":"e_1_2_9_13_1","doi-asserted-by":"crossref","first-page":"5256","DOI":"10.1007\/s10620-022-07399-7","article-title":"\u201cWet Heparin\u201d and \u201cWet Saline\u201d EUS\u2010Guided Liver Biopsy Techniques Both Provide High Rates of Specimen Adequacy for Benign Parenchymal Liver Disease","volume":"67","author":"Saraireh H.","year":"2022","journal-title":"Digestive Diseases and Sciences"},{"issue":"3","key":"e_1_2_9_14_1","doi-asserted-by":"crossref","first-page":"E356","DOI":"10.1055\/s-0043-121880","article-title":"Heparin Priming of EUS\u2010FNA Needles Does Not Adversely Affect Tissue Cytology or Immunohistochemical Staining","volume":"6","author":"Diehl D. 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A.","year":"2015","journal-title":"Clinical Cancer Research"},{"issue":"3","key":"e_1_2_9_21_1","doi-asserted-by":"crossref","first-page":"E401","DOI":"10.1055\/a-1336-3170","article-title":"Use of Suction During Endoscopic Ultrasound\u2010Guided Fine Needle Biopsy of Solid Pancreatic Lesions With a Franseen\u2010Tip Needle: A Pilot Comparative Trial","volume":"9","author":"Costa\u2010Moreira P.","year":"2021","journal-title":"Endoscopy International Open"},{"issue":"3","key":"e_1_2_9_22_1","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1007\/s13304-021-01198-x","article-title":"Performance of EUS\u2010FNB in Solid Pancreatic Masses: A Lesson From 463 Consecutive Procedures and a Practical Nomogram","volume":"74","author":"Pagano N.","year":"2022","journal-title":"Updates in Surgery"},{"issue":"2","key":"e_1_2_9_23_1","doi-asserted-by":"crossref","first-page":"318","DOI":"10.5009\/gnl220030","article-title":"Tissue Quality Comparison Between Heparinized Wet Suction and Dry Suction in Endoscopic Ultrasound\u2010Fine Needle Biopsy of Solid Pancreatic Masses: A Randomized Crossover Study","volume":"17","author":"Lin M. 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