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Background and study aims This study aimed to investigate the diagnostic accuracy and utility of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) performed using a Franseen needle on solid pancreatic lesions. Patients and methods This study included 132 consecutive lesions sampled by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) using a 22-G conventional needle and 95 consecutive lesions evaluated by EUS-FNB using a 22-G Franseen needle to evaluate solid pancreatic lesions at our medical center between July 2013 and November 2018. We used propensity-matched analysis with adjustment for confounders. Patient data were analyzed retrospectively. Results Diagnostic accuracy was higher in the Franseen needle group (Group F; 91.6 %, 87 /95) than in the conventional needle group (Group C; 86.3 %, 82 /95), showing no significant difference (P = 0.36). In Group F, diagnostic accuracies for pancreatic head lesions and lesions sampled by transduodenal puncture were 98.0 % (48/49) and 97.9 % (46/47), respectively. These values were significantly higher than values in Group C (P = 0.013, 0.01). Group F displayed a significantly lower number of punctures. In terms of differentiating benign from malignant lesions, Group C showed 85.1 % sensitivity (74/87), 100 % specificity (8/8), 100 % positive predictive value (74/74), and 38.1 % negative predictive value (8/21), compared to values of 90.1 % (73/81), 100 % (14/14), 100 % (73/73), and 63.6 % (14/22), respectively, in Group F. Sensitivity and negative predictive value were better in Group F. Conclusions Franseen needles for EUS-FNB of solid pancreatic lesions offer similar puncture performance at different lesion sites while requiring fewer punctures than conventional needles.

The aim of the study was to better define the incidence of and risk factors for early seizures after repair of unruptured intracranial aneurysms in modern microsurgical techniques. The medical records of 414 consecutive patients who underwent neck clipping of unruptured intracranial aneurysms in our institution over a 5-year period were retrospectively reviewed. Clinical and neuroimaging variables were analyzed to investigate putative predictors of perioperative seizures using multivariate logistic regression analysis. Overall, 24 patients (5.8%) developed seizures within 14 days of surgery without routine prophylactic use of anticonvulsants. Eleven patients experienced partial seizures, while 13 experienced secondary generalized seizures. The interval between surgery and seizure onset was less than 6 h in 8 patients, 6-24 h in 3, and 1-14 days in 11. History of dialysis (odds ratio [OR] = 77.6, 95% confidence interval [CI] 7.5-1783.4, P < 0.001), and presence of cerebral contusion (OR = 5.1, 95% CI 1.3-16.9, P = 0.02) or infarction (OR = 13.9, 95% CI 3.9-48.5, P < 0.001) detected by postoperative computed tomography were independent and significant risk factors. No patients with early seizures went on to develop refractory epilepsy. Dialysis and iatrogenic brain damage were associated with a higher risk of early seizures after aneurysm surgery. Our data support the selective use of anticonvulsants during the perioperative period of elective aneurysm surgery.