الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Pancreatic cancer is a challenging cancer to diagnose and treat. It is considered as the seventh leading cause of cancer-related death in both males and females worldwide because of its poor prognosis. Early detection and diagnosis are crucial for increasing the chances of successful treatment and long-term survival. There are several methods of diagnosing pancreatic cancer, EUS-FNAC and percutaneous US-FNAC being two widely used methods. FNAC is a minimally invasive procedure involving inserting a thin needle into the lesion to obtain a tissue sample for cytological examination.In recent years, EUS-FNAC has emerged as a popular diagnostic method for pancreatic cancer due to its high sensitivity and specificity On the other hand, US-FNAC is a less invasive alternative technique to it. This method is less expensive and could be performed without sedation, which is beneficial for patients who are medically unfit for an endoscopic procedure The aim of our study was to compare the diagnostic accuracy and effectiveness of US-FNAC and EUS-FNAC in diagnosing pancreatic cancer. A total of 83 patients with suspected pancreatic lesions were enrolled in the study and randomly assigned to undergo either percutaneous or endoscopic US-guided FNAC. Patients were divided into two groups: group 1 (percutaneous) included 41 patients, and group 2 (EUS) included 42 patients. All patients underwent (CT) and/ or (MRI) before the procedure to confirm the presence of a pancreatic lesion In Percutaneous transabdominal US technique. Before sampling, the pancreatic lesion was evaluated using conventional ultrasound methods to determine the best site for sampling based on factors such as the lesion’s size, depth, and vascularity. The FNA was performed through an anterior abdominal approach, the patients were placed in the supine position, and negative pressure was applied using a syringe to obtain the specimen. After the biopsy, the targeted organ was evaluated using ultrasound to detect any signs of hemorrhage or fluid accumulation EUS-FNAC was done by inserting an endoscope with an attached ultrasound probe through the mouth and into the stomach under general anesthesia, which provided a high-resolution ultrasound image of the pancreas. The patient was placed in the left lateral position and the lesion was evaluated using EUS to determine its operability and the best puncture point. Doppler and elastography were used to avoid intervening vessels and guide the needle to the hardest point of the lesion. The FNA was performed with a 22G needle under EUS guidance, using the slow-pull technique and fanning method to obtain specimens. Negative suction pressure was applied according to the pathologist request to reduce the risk of blood contamination, and the endo-sonographer confirmed that there was no bleeding before transferring the patient to the recovery room.