Published online Aug 14, 2017. doi: 10.3748/wjg.v23.i30.5610
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
Processing time: 120 Days and 15.6 Hours
To evaluate the diagnostic value and safety mainly regarding incidents of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for pancreatic cystic lesions (PCLs).
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.
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.
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.
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.