AIM:To assess the safety,yield and clinical utility of percutaneous transgastric computed tomography(CT)-guided biopsy of pancreatic tumor using large needles, in selected patients. METHODS:We reviewed 34 CT-guided biopsies in patients with pancreas mass,of whom 24(71%)had a direct path to the mass without passing through a major organ.The needle passed through the liver in one case(3%).Nine passes(26%)were made through the stomach.These nine transgastric biopsies which used a coaxial technique(i.e.a 17-gauge coaxial introducer needle and an 18-gauge biopsy needle)were the basis of this study.Immediate and late follow-up CT images to detect complications were obtained. RESULTS:Tumor tissues were obtained in nine pancreatic biopsies,and histologic specimens for diagnosis were obtained in all cases.One patient,who had a rare sarco-matoid carcinoma,received a second biopsy.One patient had a complication of transient pneumoperitoneum but no subjective complaints.An immediate imaging study and clinical follow-up detected neither hemorrhage nor peritonitis.No delayed procedure-related complication was seen during the survival period of our patients.CONCLUSION:Pancreatic biopsy can be obtained by a transgastric route using a large needle as an alternative method,without complications of peritonitis or bleeding. AIM: To assess the safety, yield and clinical utility of percutaneous transgastric computed tomography (CT) -guided biopsy of pancreatic tumor using large needles, in selected patients. METHODS: We reviewed 34 CT-guided biopsies in patients with pancreas mass, of whom 24 (71%) had a direct path to the mass without passing through a major organ. The needle passed the liver in one case (3%). Nine passes (26%) were made through the stomach. These nine transgastric biopsies which used a coaxial technique (iea 17-gauge coaxial introducer needle and an 18-gauge biopsy needle) were the basis of this study. Immediate and late follow-up CT images were obtained for the detection of lesions. RESULTS: Tumor tissues were obtained in nine pancreatic biopsies, and histologic specimens for diagnosis were obtained in all cases. One patient, who had a rare sarco-matoid carcinoma, received a second biopsy. One patient had a complication of transient pneumoperitoneum but no subjective complaints. and clinical follow-up detected neither hemorrhage nor peritonitis. No delayed procedure-related complication was seen during the survival period of our patients. CONCLUSION: Pancreatic biopsy can be obtained by a transgastric route using a large needle as an alternative method, without complications of peritonitis or bleeding.