title: Assessment of morbidity and mortality associated with EUS-guided FNA: a systematic review.
abstract: BACKGROUND
  EUS-guided FNA (EUS-FNA) permits both morphologic and cytologic analysis of lesions within or adjacent to the GI tract. Although previous studies have evaluated the accuracy of EUS-FNA, little is known about the complications of EUS-FNA. Moreover, the frequency and severity of complications may vary from center to center and may be related to differences in individual experience.
  
  
  OBJECTIVE
  To systematically review the morbidity and mortality associated with EUS-FNA.
  
  
  METHODS
  MEDLINE and EMBASE were searched to identify relevant English-language articles.
  
  
  METHODS
  EUS-FNA-specific morbidity and mortality rates.
  
  
  RESULTS
  We identified 51 articles with a total of 10,941 patients who met our inclusion and exclusion criteria; the overall rate of EUS-FNA-specific morbidity was 0.98% (107/10,941). In the small proportion of patients with complications of any kind, the rates of pancreatitis (36/8246; 0.44%) and postprocedure pain (37/10,941; 0.34%) were 33.64% (36/107) and 34.58% (37/107), respectively. The mortality rate attributable to EUS-FNA-specific morbidity was 0.02% (2/10,941). Subgroup analysis showed that the morbidity rate was 2.44% in prospective studies compared with 0.35% in retrospective studies for pancreatic mass lesions (P=.000), whereas it was 2.33% versus 5.07% for pancreatic cysts (P=.036).
  
  
  CONCLUSIONS
  Few articles reported well-designed, prospective studies and few focused on overall complications after EUS-FNA.
  
  
  CONCLUSIONS
  EUS-FNA-related morbidity and mortality rates are relatively low, and most associated events are mild to moderate in severity.
authors.affiliation: Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Kai-Xuan
authors.initials: KX
authors.lastname: Wang
authors.forename: Qi-Wen
authors.initials: QW
authors.lastname: Ben
authors.forename: Zhen-Dong
authors.initials: ZD
authors.lastname: Jin
authors.forename: Yi-Qi
authors.initials: YQ
authors.lastname: Du
authors.forename: Duo-Wu
authors.initials: DW
authors.lastname: Zou
authors.forename: Zhuan
authors.initials: Z
authors.lastname: Liao
authors.forename: Zhao-Shen
authors.initials: ZS
authors.lastname: Li
mesh_terms: D044963:Biopsy, Fine-Needle / Q000009:adverse effects* / Q000379:methods; D004066:Digestive System Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D019160:Endosonography / Q000009:adverse effects*; D014943:Global Health; D006801:Humans; D009017:Morbidity / Q000639:trends; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends