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Gastrointest Endosc. 2011 Feb;73(2):283-90. doi: 10.1016/j.gie.2010.10.045.

Assessment of morbidity and mortality associated with EUS-guided FNA: a systematic review.

Author information

1
Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.

Abstract

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.

Comment in

PMID:
21295642
DOI:
10.1016/j.gie.2010.10.045
[Indexed for MEDLINE]

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