title: Factors predictive of adverse events associated with endoscopic ultrasound-guided fine needle aspiration of pancreatic solid lesions.
abstract: BACKGROUND
  Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) provides high diagnostic accuracy with a low incidence of procedural complications. However, it occasionally causes serious complications, and factors that increase the susceptibility to such adverse events remain unknown.
  
  
  OBJECTIVE
  We aimed to examine post-procedural events and determine risk factors associated with EUS-FNA of pancreatic solid lesions.
  
  
  METHODS
  This single-center retrospective study included 316 consecutive patients with pancreatic solid lesions who underwent 327 EUS-FNA procedures from April 2003 to September 2011. We registered all patients undergoing EUS-FNA in the database and retrospectively ascertained the presence/absence of post-procedural adverse events.
  
  
  RESULTS
  The incidence of post-procedural adverse events, including moderate to mild pancreatitis, mild abdominal pain, and mild bleeding, was 3.4 %. Univariate analysis showed that the incidence of post-procedural events was significantly increased in patients with tumors less than or equal to 20 mm in diameter (P < 0.001), those with pancreatic neuroendocrine tumors (PNET) (P = 0.012), and patients who had intervening normal pancreas for accessing the lesion (P = 0.048). Multivariate analysis identified tumors measuring less than or equal to 20 mm in diameter (OR 18.48; 95 % CI 3.55-96.17) and case of PNETs (OR 36.50; 95 % CI 1.73-771.83) were an independent risk factors.
  
  
  CONCLUSIONS
  EUS-FNA of pancreatic solid lesions is a safe procedure. However, pancreatic lesions with small diameters and pancreatic neuroendocrine tumors are important factors associated with adverse events after EUS-FNA.
authors: Center for Gastroenterology, Teine-Keijinkai Hospital, 1-40-1-12 Maeda, Teine-ku, Sapporo, Hokkaido 006-8555, Japan. akio-ka@ta2.so-net.ne.jp
authors: Akio
authors: A
authors: Katanuma
authors: Hiroyuki
authors: H
authors: Maguchi
authors: Kei
authors: K
authors: Yane
authors: Shunpei
authors: S
authors: Hashigo
authors: Toshihumi
authors: T
authors: Kin
authors: Maki
authors: M
authors: Kaneko
authors: Shin
authors: S
authors: Kato
authors: Ryusuke
authors: R
authors: Kato
authors: Ryo
authors: R
authors: Harada
authors: Manabu
authors: M
authors: Osanai
authors: Kuniyuki
authors: K
authors: Takahashi
authors: Masanori
authors: M
authors: Nojima
mesh_terms: D015746:Abdominal Pain / Q000453:epidemiology / Q000209:etiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000009:adverse effects*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D010195:Pancreatitis / Q000453:epidemiology / Q000209:etiology*; D050500:Pancreatitis, Chronic / Q000000981:diagnostic imaging / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors