Answer is “If you have solid technique of course you can.” Measure out well on distance of trajectory, adjust angle to avoid vessels, get a variety of echotexture in the trajectory and stick.” Practice on cadavers and if you can stick the target spot at a variety of angles 10x in a row you are ready to go live. This is my training rule on Bx and sampling.

Regarding the pancreas and needles: Differentiating chronic pancreatitis/necrosis from neoplasia is important and core bx is the best way to do this as neoplasia and inflammation go together. FNA is fine as well as long as you stick a variety of presentations but core is always best. I grew up in the US world of “OMG you can’t stick a pancreas the world will stop turning” mentality. Well this is far from the truth. I have (knock on wood) in 15 years as a clinical sonographer throwing needles around and thousands of cases/year and mentoring several sonographers that do the same I never ever have had a complication of any sort sticking a pancreas. I get more complication scenarios listed in this liver biopsy post  than I ever do with a panc stick:

http://sonopath.com/forum/core-liver-biopsy-question

Every pancreatic sampling case in the sonopath archive and in my personal archive has never had a complication and we are in the hundreds of  cases of panc sticks between FNA, Core bx , abscess drainage and baytril injection into drained cavities. If anyone wants to coauthor this study I will give you the pile to write up:)

Another important piece of info we get from core bx or even fna of the pancreas is the dominant inflammatory cell type. If lymphoplasmacytic inflammation is dominant pred is often needed and justified or more of an IBD/triad protocol is likely going to be necessary. If neutrophilic dominates then traditional pancreatitis tx is more in order. So lets all start sticking pancreas with solid technique (disclaimer disclaimer….:) and see what great info you get.

Look at this case of a pancreatic mass in this bengal cat. Core bx with very concerned owner (of course its a Bengal cat owner … the feline version of a yorkie owner:)….= pancreatic adenoma. Looks ugly but is actually benign and happy owner, happy cat, happy client.