Pancreatic endoscopic ultrasound-guided fine needle aspiration: complication rate and clinical course in a single centre.
BACKGROUND
Endoscopic Ultrasound-guided Fine Needle Aspiration (EUS-FNA) is effective for obtaining biopsy specimens from pancreatic lesions.


OBJECTIVE
To determine the frequency and severity of complications after EUS-FNA of solid and cystic pancreatic lesions in a single centre large series of patients.


METHODS
From January 2005 to December 2008, information on all patients referred to our unit for pancreatic EUS was systematically entered in a computer database including clinical and morphologic data. Records were reviewed to evaluate whether complications such as haemorrhage, acute pancreatitis, intestinal perforation, or others occurred after EUS-FNA of the pancreas.


RESULTS
A total of 3296 pancreatic EUS were done in four years. In the 1034 pancreatic EUS-FNA, we observed 10 (0.96%) haemorrhages (7 intracystic, 2 in the pancreatic duct, and 1 in a small carcinoma), 2 (0.19%) acute severe pancreatitis and 1 (0.09%) duodenal perforation followed by complicated post-surgical hospitalization and death. The haemorrhages were all self-limiting. Overall, major complications (pancreatitis and perforation) arose in 0.29% of these examinations.


CONCLUSIONS
EUS-FNA is safe, with a low risk of severe haemorrhage. Although rare, acute pancreatitis is generally mild or severe, requiring prolonged hospitalization. One fatal complication occurred after duodenal perforation in a patient with duodenal neuroendocrine tumour and pancreatic infiltration.
Carrara
Silvia
S
Division of Gastroenterology & Gastrointestinal Endoscopy, Vita-Salute San Raffaele University, San Raffaele Scientific Institute, Milan, Italy. carrara.silvia@hsr.it
Arcidiacono
Paolo Giorgio
PG
Mezzi
Gianni
G
Petrone
Maria Chiara
MC
Boemo
Cinzia
C
Testoni
Pier Alberto
PA
D044963:Biopsy, Fine-Needle / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D010181:Pancreatic Cyst / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D010195:Pancreatitis / Q000209:etiology*; D019106:Postoperative Hemorrhage / Q000209:etiology*; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional