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Comparative Study
. 2017 Aug 14;23(30):5610-5618.
doi: 10.3748/wjg.v23.i30.5610.

Incidents and adverse events of endoscopic ultrasound-guided fine-needle aspiration for pancreatic cystic lesions

Chen Du  1 , Ning-Li Chai  1 , En-Qiang Linghu  1 , Hui-Kai Li  1 , Yu-Fa Sun  1 , Wei Xu  1 , Xiang-Dong Wang  1 , Ping Tang  1 , Jing Yang  1
Affiliations
Comparative Study

Incidents and adverse events of endoscopic ultrasound-guided fine-needle aspiration for pancreatic cystic lesions

Chen Du et al. World J Gastroenterol. .

Abstract

Aim: To evaluate the diagnostic value and safety mainly regarding incidents of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for pancreatic cystic lesions (PCLs).

Methods: A total of 150 consecutive patients with suspected PCLs were prospectively enrolled from April 2015 to November 2016. We finally enrolled 140 patients undergoing EUS-FNA. We compared the diagnostic accuracy of EUS-FNA and pathological diagnosis, which is regarded as the gold standard, for PCLs. Patients undergoing EUS-FNA at least 1 wk preoperatively were monitored for incidents and adverse events to evaluate its safety.

Results: There were 88 (62.9%) women and 52 (37.1%) men among 140 patients, with a mean age of 50.1 (± 15.4) years. There were 67 cysts located in the head/uncinate of the pancreas and 67 in the body/tail, and 6 patients had at least 1 cyst in the pancreas. There were 75 patients undergoing surgery and 55 undergoing EUS-FNA with interval at least 1 wk before other operations, with 3 patients undergoing the procedure twice. The accuracy of EUS-FNA in differentiating benign and malignant lesions was 97.3% (73/75), while the accuracy of characterizing PCL subtype was 84.0% (63/75). The incident rate was 37.9% (22/58), whereas only 1 AE was observed in 58 cases.

Conclusion: EUS-FNA is effective and safe for diagnosis of PCLs, however procedure-related incidents are common. Caution should be taken in patients undergoing EUS-FNA.

Keywords: Endoscopic ultrasound; Fine-needle aspiration; Incident; Pancreatic cystic lesion.

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Conflict of interest statement

Conflict-of-interest statement: There are no conflicts of interest in relation to this manuscript.

Figures

Figure 1
Figure 1
The procedures of endoscopic ultrasound-guided fine-needle aspiration. A: Endoscopic ultrasound view of the cyst, showing a 46.0 mm2 × 39.0 mm2 cyst in pancreatic neck; B: Puncture of the cyst with a 19-guage needle and aspiration of the cystic fluid; C: Specimen of cystic fluid, sent for cytology and biochemical analysis; D: Histopathological image of cystic fluid cytology, diagnosed with serous cystic neoplasm (H and E, × 100); E: Histopathological image of cystic fluid cytology (H and E, × 200); F: Histopathological image of biopsy of the cystic wall of the same cyst (H and E, × 10); G: Histopathological image of biopsy of the cystic wall of the same cyst (H and E, × 40).
Figure 2
Figure 2
Study flowchart. ERCP: Endoscopic retrograde cholangiopancreatography; EUS-FNA: Endoscopic ultrasound-guided fine-needle aspiration; PCLs: Pancreatic cystic lesions.
See this image and copyright information in PMC

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