title: The efficacy and safety of single-session endoscopic ultrasound-guided fine needle aspiration and endoscopic retrograde cholangiopancreatography for evaluation of pancreatic masses.
abstract: OBJECTIVE
  There have been limited studies evaluating single-session EUS-FNA and ERCP for evaluation of pancreatic masses. The aim of this study was to determine the safety of single-session EUS-FNA and ERCP, and to compare the diagnostic accuracies of cytodiagnosis by EUS-FNA, ERCP, and their combination.
  
  
  METHODS
  A total of 100 patients with pancreatic masses were prospectively enrolled. All patients underwent single-session EUS-FNA and ERCP. The main outcome measurement was frequency of post-procedural complications. Another measurement was diagnostic accuracy of cytodiagnosis by EUS-FNA, ERCP, and their combination.
  
  
  RESULTS
  Procedure-related pancreatitis occurred in 10 patients, but all patients were conservatively managed. Cytodiagnosis by EUS-FNA was significantly superior to ERCP in accuracy. In patients with a pancreatic head mass, 3 cases of false negative EUS-FNA were positive on ERCP. The combination procedures improved accuracy compared with EUS-FNA alone. By contrast, in the subgroup of the pancreatic body or tail mass, the combination of EUS-FNA and ERCP did not improve cytodiagnosis compared to that with EUS-FNA alone.
  
  
  CONCLUSIONS
  Single-session EUS-FNA and ERCP appears to be as safe as performing each procedure separately. EUS-FNA should be considered the principal procedure for cytodiagnosis. ERCP has only a complementary role in patients with pancreatic head mass.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Noma
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kawamoto
authors.forename: Hironari
authors.initials: H
authors.lastname: Kato
authors.forename: Masaya
authors.initials: M
authors.lastname: Iwamuro
authors.forename: Ken
authors.initials: K
authors.lastname: Hirao
authors.forename: Masakuni
authors.initials: M
authors.lastname: Fujii
authors.forename: Koichiro
authors.initials: K
authors.lastname: Tsutsumi
authors.forename: Shigeru
authors.initials: S
authors.lastname: Horiguchi
authors.forename: Naoki
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Ichiro
authors.initials: I
authors.lastname: Sakakihara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tomoda
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okada
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Yamamoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D003581:Cytodiagnosis; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000009:adverse effects; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery; D010195:Pancreatitis / Q000209:etiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D055815:Young Adult