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Frequency of major complications after EUS-guided FNA of solid pancreatic masses: a prospective evaluation

Background EUS-guided FNA (EUS-FNA) is effective for establishing a tissue diagnosis in suspected pancreatic cancer. However, data on the frequency of major complications after EUS-FNA are limited. The objective was to evaluate the frequency of major complications after EUS-FNA of solid pancreatic m...

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Published in:Gastrointestinal endoscopy 2006-04, Vol.63 (4), p.622-629
Main Authors: Eloubeidi, Mohamad A., MD, MHS, Tamhane, Ashutosh, MD, MSPH, Varadarajulu, Shyam, MD, Wilcox, C. Mel, MD
Format: Article
Language:English
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Summary:Background EUS-guided FNA (EUS-FNA) is effective for establishing a tissue diagnosis in suspected pancreatic cancer. However, data on the frequency of major complications after EUS-FNA are limited. The objective was to evaluate the frequency of major complications after EUS-FNA of solid pancreatic masses. Methods This was a prospective cohort study. The setting was a tertiary, university-based referral center for pancreaticobiliary disorders. Over a 42-month period, consecutive patients who underwent EUS-FNA of a solid pancreatic were included in the study. All immediate complications were recorded by the endosonographer. Late complications were assessed at 72 hours and at 30 days after the procedure. Major complications were defined as acute pancreatitis, bleeding, infection, perforation, use of reversal medication, hospitalization or death. Results A total of 355 consecutive patients with a solid pancreatic mass underwent EUS-FNA. Major complications were encountered in 9 patients (2.54%: 95% CI[1.17, 4.76]). Acute pancreatitis occurred in 3/355 (0.85%: 95% CI[0.17, 2.45]), two patients were hospitalized, and one patient recovered with outpatient analgesics. Three patients were admitted for severe pain after the procedure all of whom were treated with analgesics and, subsequently, were discharged with no sequela. Two patients (0.56%: 95% CI[0.07, 2.02]) developed fever and were admitted for intravenous antibiotics: one patient recovered with intravenous antibiotics, and the other patient required surgical debridement for necrosis. One patient required the use of reversal medication. Overall, 1.97%: 95% CI[0.80, 4.02] of the patients were hospitalized for complications (range 1-16 days). None of the patients experienced clinically significant hemorrhage, perforation, or death. No clear predisposing risk factors were identified. Limitations of the study were lack of a surgical criterion standard and referral to a tertiary center. Conclusions EUS-FNA of solid pancreatic masses infrequently leads to major complications. Our results can be used by endosonographers to counsel patients before EUS-FNA of solid pancreatic masses.
ISSN:0016-5107
1097-6779
DOI:10.1016/j.gie.2005.05.024