Background: Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) is safe and effective for the diagnosis of pancreatic adenocarcinoma. Although rapid on-site evaluation (ROSE) can improve tissue collection and increase diagnostic yield, its utility has been recently questioned. Objective: Determine the diagnostic efficacy of EUS-FNB with ROSE of pancreatic masses in a new echoendoscopy unit. Methods: Cross-sectional and comparative study of patients who underwent EUS-FNB of pancreatic masses between January and July 2017. Patient demographics, ultrasonographic details, and pathology reports were examined. Results: A total of 23 procedures were analyzed. Median age was 59 years (range: 46-77). The group with ROSE had 13 patients (56.5%) and the group without ROSE 10 (43.5%). The final pathology report showed enough and adequate sample in 100% of the group with ROSE (13/13 vs. 5/10; p = 0.007). Diagnosis of malignancy was established in 84.6% of the biopsies (11/13 vs. 2/10; p = 0.003) in the group with ROSE. Conclusions: ROSE is useful to improve the diagnostic efficacy of EUS-FNB of pancreatic masses, especially in new EUS centers or in centers with a low diagnostic yield.

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