Prospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 14, 2017; 23(30): 5610-5618
Published online Aug 14, 2017. doi: 10.3748/wjg.v23.i30.5610
Incidents and adverse events of endoscopic ultrasound-guided fine-needle aspiration for pancreatic cystic lesions
Chen Du, Ning-Li Chai, En-Qiang Linghu, Hui-Kai Li, Yu-Fa Sun, Wei Xu, Xiang-Dong Wang, Ping Tang, Jing Yang
Chen Du, Ning-Li Chai, En-Qiang Linghu, Hui-Kai Li, Xiang-Dong Wang, Ping Tang, Jing Yang, Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing 100853, China
Yu-Fa Sun, Wei Xu, Department of Health Care, Central Guard Bureau, Beijing 100034, China
Author contributions: Chai NL, Linghu EQ and Li HK designed the research; Du C, Chai NL, Linghu EQ, Li HK, Sun YF, Xu W, Wang XD, Tang P and Yang J performed the research; Du C analyzed the data; and Du C wrote the paper.
Institutional review board statement: The clinical trial described in this paper was reviewed and approved by the Committee of Medical Ethics of Chinese PLA General Hospital.
Clinical trial registration statement: The study is registered at http://www.chictr.org.cn/showproj.aspx?proj=10604. The registration identification number is ChiCTR-OOC-15006118.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest in relation to this manuscript.
Data sharing statement: There are no additional data available in relation to this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: En-Qiang Linghu, MD, Department of Gastroenterology, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China. linghuenqiang@vip.sina.com
Telephone: +86-10-68182255-499292 Fax: +86-10-55499292
Received: April 15, 2017
Peer-review started: April 15, 2017
First decision: June 1, 2017
Revised: June 12, 2017
Accepted: June 18, 2017
Article in press: June 19, 2017
Published online: August 14, 2017
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, Incident, Fine-needle aspiration, Pancreatic cystic lesion

Core tip: Incidents are self-limiting and do not change therapy. Adverse events (AEs) of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) have attracted attention, whereas incidents are almost ignored. Although incidents do not interfere with procedures and treatment, documenting them might improve procedural quality and prediction of AEs. Our study was designed to evaluate the diagnostic value and safety mainly regarding incidents of EUS-FNA. We found the accuracy of EUS-FNA in differentiating benign and malignant lesions and characterizing pancreatic cystic lesions subtype was high. The AE rate was low, however procedure-related incidents are common and should be paid attention to.