Thanks, Gavin for posting this.
Please note last sentence in abstract:
There is also controversy regarding the role of EUS-FNA, since even though this may increase diagnosis, it can also lead to tumor seeding.
I may add:
Biliary brushings are needed for the diagnosis however; percutaneous biopsies and/or biopsies performed at the time of endoscopic ultrasound should be discouraged. It may exclude possible inclusion for liver transplantation.
THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. YOU SHOULD ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROVIDER