{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T19:30:28Z","timestamp":1776972628499,"version":"3.51.4"},"reference-count":98,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T00:00:00Z","timestamp":1721692800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Pancreatic cystic lesions (PCLs) pose a diagnostic challenge due to their increasing incidence and the limitations of cross-sectional imaging and endoscopic-ultrasound-guided fine-needle aspiration (EUS-FNA). EUS-guided through the needle biopsy (EUS-TTNB) has emerged as a promising tool for improving the accuracy of cyst type determination and neoplastic risk stratification. EUS-TTNB demonstrates superior diagnostic performance over EUS-FNA, providing critical preoperative information that can significantly influence patient management and reduce unnecessary surgeries. However, the procedure has risks, with an overall adverse event rate of approximately 9%. Preventive measures and further prospective studies are essential to optimize its safety and efficacy. This review highlights the potential of EUS-TTNB to enhance the diagnostic and management approaches for patients with PCLs. It examines the current state of EUS-TTNB, including available devices, indications, procedural techniques, specimen handling, diagnostic yield, clinical impact, and associated adverse events.<\/jats:p>","DOI":"10.3390\/diagnostics14151587","type":"journal-article","created":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T14:26:50Z","timestamp":1721744810000},"page":"1587","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Endoscopic Ultrasound-Guided Through-the-Needle Biopsy: A Narrative Review of the Technique and Its Emerging Role in Pancreatic Cyst Diagnosis"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7041-0863","authenticated-orcid":false,"given":"Filipe","family":"Vilas-Boas","sequence":"first","affiliation":[{"name":"Gastroenterology Department, Centro Hospitalar e Universit\u00e1rio de S\u00e3o Jo\u00e3o, Faculdade de Medicina da Universidade do Porto, 4200-349 Porto, Portugal"}]},{"given":"Tiago","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Centro Hospitalar e Universit\u00e1rio de S\u00e3o Jo\u00e3o, Faculdade de Medicina da Universidade do Porto, 4200-349 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9387-9872","authenticated-orcid":false,"given":"Guilherme","family":"Macedo","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Centro Hospitalar e Universit\u00e1rio de S\u00e3o Jo\u00e3o, Faculdade de Medicina da Universidade do Porto, 4200-349 Porto, Portugal"}]},{"given":"Jahnvi","family":"Dhar","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9277-5086","authenticated-orcid":false,"given":"Jayanta","family":"Samanta","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3700-6989","authenticated-orcid":false,"given":"Sokol","family":"Sina","sequence":"additional","affiliation":[{"name":"Department of Diagnostics and Public Health, University of Verona, 37129 Verona, Italy"}]},{"given":"Erminia","family":"Manfrin","sequence":"additional","affiliation":[{"name":"Department of Diagnostics and Public Health, University of Verona, 37129 Verona, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2107-2156","authenticated-orcid":false,"given":"Antonio","family":"Facciorusso","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7813-1583","authenticated-orcid":false,"given":"Maria Cristina","family":"Conti Bellocchi","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, University Hospital of Verona, 37134 Verona, Italy"}]},{"given":"Nicol\u00f2","family":"De Pretis","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, University Hospital of Verona, 37134 Verona, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7417-2655","authenticated-orcid":false,"given":"Luca","family":"Frulloni","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, University Hospital of Verona, 37134 Verona, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4560-8741","authenticated-orcid":false,"given":"Stefano Francesco","family":"Crin\u00f2","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, University Hospital of Verona, 37134 Verona, Italy"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.pan.2018.11.014","article-title":"Systematic review and meta-analysis: Prevalence of incidentally detected pancreatic cystic lesions in asymptomatic individuals","volume":"19","author":"Zerboni","year":"2019","journal-title":"Pancreatology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1136\/gutjnl-2016-313127","article-title":"Prospective study on the incidence, prevalence and 5-year pancreatic-related mortality of pancreatic cysts in a population-based study","volume":"67","author":"Kromrey","year":"2018","journal-title":"Gut"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/j.cgh.2015.08.038","article-title":"Association Between Advances in High-Resolution Cross-Section Imaging Technologies and Increase in Prevalence of Pancreatic Cysts From 2005 to 2014","volume":"14","author":"Moris","year":"2016","journal-title":"Clin. 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