Factors predictive of adverse events associated with endoscopic ultrasound-guided fine needle aspiration of pancreatic solid lesions

Dig Dis Sci. 2013 Jul;58(7):2093-9. doi: 10.1007/s10620-013-2590-4. Epub 2013 Feb 20.

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.

Aims: 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.

Publication types

  • Evaluation Study

MeSH terms

  • Abdominal Pain / epidemiology
  • Abdominal Pain / etiology*
  • Adult
  • Aged
  • Aged, 80 and over
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration / adverse effects*
  • Female
  • Gastrointestinal Hemorrhage / epidemiology
  • Gastrointestinal Hemorrhage / etiology*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Neuroendocrine Tumors / diagnostic imaging
  • Neuroendocrine Tumors / pathology*
  • Pancreatic Neoplasms / diagnostic imaging
  • Pancreatic Neoplasms / pathology*
  • Pancreatitis / epidemiology
  • Pancreatitis / etiology*
  • Pancreatitis, Chronic / diagnostic imaging
  • Pancreatitis, Chronic / pathology*
  • Retrospective Studies
  • Risk Factors