对于手术候选者来说，对疑似胰腺癌（PDAC）进行活检是有帮助的，但并非始终必要。活检对治疗选择产生影响，因为新辅助疗法目前要求组织学诊断，但对于外科切除手术来说并非必须。我们探讨了通过内窥镜超声（EUS）活检获取组织诊断对可切除和边缘可切除PDAC患者治疗时间的影响。对最终证实患有PDAC的手术患者进行了回顾性研究（2011-2021）。收集了里程碑日期（疑似癌症、活检、外科手术或新辅助治疗）。使用Mann-Whitney-Wilcoxon检验、Pearson卡方检验、Fisher精确检验、线性回归和Cox比例风险模型进行数据分析。在131例可切除和58例边缘可切除患者中，边缘可切除组进行了更多的活检（1.2次与0.7次，p < 0.0001），更有可能在三级保健中心进行活检（67.2% vs 30.5%，p < 0.0001），且趋向于治疗时间较长（49 vs 44天，p = 0.070）。在黑人种群（29天，p = 0.0002）和医疗保险为医疗保险为Medicare（22天，p = 0.038）且未在三级保健中心进行活检的患者中，治疗时间显著增加（10天，p = 0.039）。在调整了协变量后，额外活检明显延迟了治疗时间（1次活检：21天，p = 0.0001；2次活检：44天，p < 0.0001；3次活检：68天，p < 0.0001）。EUS活检显著影响疑似PDAC与治疗之间的时间。这可能受到临床实践日益偏向新辅助疗法（需要经活检证实的疾病）的影响。治疗时间还可能受到接受三级保健中心服务的能力和种族差异的影响。© 2022年。肠道外科学会（The Society for Surgery of the Alimentary Tract）。

Biopsy of suspected pancreatic cancer (PDAC) in surgical candidates is informative however not always necessary. Biopsies impact treatment options as histological diagnosis are presently required for neo-adjuvant therapy, but not surgical resection. We explored the impact of pursuing tissue diagnosis by endoscopic ultrasound (EUS) biopsy on time to treatment in patients with resectable and borderline resectable PDAC.A retrospective review of surgical patients with ultimately proven PDAC was performed (2011-2021). Milestone dates (cancer suspected, biopsy(ies), surgical or neo-adjuvant treatment) were collected. Mann-Whitney-Wilcoxon tests, Pearson's chi-squared tests, Fisher's exact tests, linear regressions, and Cox proportional hazard models were used for data analysis.Among 131 resectable and 58 borderline resectable patients, the borderline resectable group underwent more biopsies (1.2 vs 0.7, p < 0.0001), were more likely to undergo biopsy at tertiary care centers (67.2% vs 30.5%, p < 0.0001), and trended toward longer time to treatment (49 vs 44 days, p = 0.070). Significant increases in days to treatment were seen in patients with Black race (29 days, p = 0.0002) and Medicare insurance (22 days, p = 0.038) and no biopsies at a tertiary care center (10 days, p = 0.039). After adjusting for covariates, additional biopsies significantly delayed treatment (1 biopsy: 21 days, p = 0.0001; 2 biopsies: 44 days, p < 0.0001; 3 biopsies: 68 days, p < 0.0001).EUS biopsy significantly impacts time between suspicion and treatment of PDAC. This may be exacerbated by clinical practices increasingly favoring neo-adjuvant therapy that necessitates biopsy-proven disease. Time to treatment may also be impacted by access to tertiary centers and racial disparities.© 2022. The Society for Surgery of the Alimentary Tract.