Background
EUS-guided FNA (EUS-FNA) permits both morphologic and cytologic analysis of lesions
within or adjacent to the GI tract. Although previous studies have evaluated the accuracy
of EUS-FNA, little is known about the complications of EUS-FNA. Moreover, the frequency
and severity of complications may vary from center to center and may be related to
differences in individual experience.
Objective
To systematically review the morbidity and mortality associated with EUS-FNA.
Design
MEDLINE and EMBASE were searched to identify relevant English-language articles.
Main Outcome Measurements
EUS-FNA-specific morbidity and mortality rates.
Results
We identified 51 articles with a total of 10,941 patients who met our inclusion and
exclusion criteria; the overall rate of EUS-FNA-specific morbidity was 0.98% (107/10,941).
In the small proportion of patients with complications of any kind, the rates of pancreatitis
(36/8246; 0.44%) and postprocedure pain (37/10,941; 0.34%) were 33.64% (36/107) and
34.58% (37/107), respectively. The mortality rate attributable to EUS-FNA-specific
morbidity was 0.02% (2/10,941). Subgroup analysis showed that the morbidity rate was
2.44% in prospective studies compared with 0.35% in retrospective studies for pancreatic
mass lesions (P = .000), whereas it was 2.33% versus 5.07% for pancreatic cysts (P = .036).
Limitations
Few articles reported well-designed, prospective studies and few focused on overall
complications after EUS-FNA.
Conclusions
EUS-FNA-related morbidity and mortality rates are relatively low, and most associated
events are mild to moderate in severity.
Abbreviation:
EUS-FNA (EUS-guided FNA)To read this article in full you will need to make a payment
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Article info
Publication history
Accepted:
October 21,
2010
Received:
May 28,
2010
Footnotes
DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
See CME section; p. 345
Identification
Copyright
© 2011 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
