EUS-guided fine-needle aspiration of the pancreas: evaluation of pancreatitis as a complication.
BACKGROUND
EUS-guided fine-needle aspiration is rapidly becoming the procedure of choice for the diagnostic evaluation of pancreatic masses. Acute pancreatitis has been reported after EUS-guided fine-needle aspiration of the pancreas. This study evaluated the effect of EUS-guided fine-needle aspiration on the pancreas by serial measurement of amylase and lipase levels and determining the frequency of acute pancreatitis after EUS-guided fine-needle aspiration of pancreatic masses.


METHODS
In 100 consecutive patients referred for EUS-guided fine-needle aspiration of a pancreatic mass, amylase and lipase levels were determined immediately before and within 2 hours after the procedure. Additionally, patients were questioned as to the occurrence of symptoms of acute pancreatitis within 48 hours after EUS-guided fine-needle aspiration.


RESULTS
For 2 of 100 patients (2%) there was clinical and biochemical evidence of acute pancreatitis after EUS-guided fine-needle aspiration. Both patients had a history of recent pancreatitis. In addition, there was a significant increase in postprocedure lipase levels (p = 0.40) compared with amylase levels in this patient subset.


CONCLUSIONS
The frequency of acute pancreatitis after EUS-guided fine-needle aspiration of the pancreas was 2% in this study. A history of recent pancreatitis appears to be a potential risk factor. Amylase and lipase levels can be elevated after EUS-guided fine-needle aspiration and in most cases have no clinical significance.
Gress
Frank
F
Division of Gastroenterology, Hepatology and Nutrition, Winthrop-University Hospital, State University of New York at Stony Brook, School of Medicine and Health Sciences Center, Long Island, USA.
Michael
Hazar
H
Gelrud
Daniel
D
Patel
Panjak
P
Gottlieb
Klaus
K
Singh
Frank
F
Grendell
James
J
D000368:Aged; D000681:Amylases / Q000097:blood; D001707:Biopsy, Needle / Q000009:adverse effects / Q000379:methods; D019160:Endosonography; D005260:Female; D006801:Humans; D008049:Lipase / Q000097:blood; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology*; D010182:Pancreatic Diseases / Q000473:pathology*; D010195:Pancreatitis / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors
D008049:Lipase; D000681:Amylases