Acute pancreatitis after EUS-guided FNA of solid pancreatic masses

A pooled analysis from EUS centers in the United States

Mohamad A. Eloubeidi, Frank G. Gress, Thomas J. Savides, Maurits J. Wiersema, Michael L. Kochman, Nuzhat A. Ahmad, Gregory G. Ginsberg, Richard A. Erickson, John DeWitt, Jacques Van Dam, Nicholas J. Nickl, Michael J. Levy, Jonathan E. Clain, Amitabh Chak, Michael V. Sivak, Richard Wong, Gerard Isenberg, James M. Scheiman, Brenna Bounds, Michael B. Kimmey & 14 others Michael D. Saunders, Kenneth J. Chang, Ashish Sharma, Phoniex Nguyen, John G. Lee, Steven A. Edmundowicz, Dayna Early, Riad Azar, Babak Etemad, Yang K. Chen, Irving Waxman, Vanessa Shami, Mark F. Catalano, C. Mel Wilcox

Research output: Contribution to journalArticle

122 Citations (Scopus)

Abstract

Background The aim of this study was to determine the frequency and the severity of pancreatitis after EUS-guided FNA of solid pancreatic masses. A survey of centers that offer training in EUS in the United States was conducted. Methods A list of centers in which training in EUS is offered was obtained from the Web site of the American Society for Gastrointestinal Endoscopy. Designated program directors were contacted via e-mail. The information requested included the number of EUS-guided FNA procedures performed for solid pancreatic masses, the number of cases of post-procedure pancreatitis, and the method for tracking complications. For each episode of pancreatitis, technical details were obtained about the procedure, including the location of the mass, the type of fine needle used, the number of needle passes, and the nature of the lesion. Results Nineteen of the 27 programs contacted returned the questionnaire (70%). In total, 4909 EUS-guided FNAs of solid pancreatic masses were performed in these 19 centers over a mean of 4 years (range 11 months to 9 years). Pancreatitis occurred after 14 (0.29%): 95% CI[0.16, 0.48] procedures. At two centers in which data on complications were prospectively collected, the frequency of acute pancreatitis was 0.64%, suggesting that the frequency of pancreatitis in the retrospective cohort (0.26%) was under-reported (p=0.22). The odds that cases of pancreatitis would be reported were 2.45 greater for the prospective compared with the retrospective cohort (95% CI[0.55, 10.98]). The median duration of hospitalization for treatment of pancreatitis was 3 days (range 1-21 days). The pancreatitis was classified as mild in 10 cases, moderate in 3, and severe in one; one death (proximate cause, pulmonary embolism) occurred after the development of pancreatitis in a patient with multiple comorbid conditions. Conclusions EUS-guided FNA of solid pancreatic masses is infrequently associated with acute pancreatitis. The procedure appears to be safe when performed by experienced endosonographers. The frequency of post EUS-guided FNA pancreatitis may be underestimated by retrospective analysis.

Original languageEnglish (US)
Pages (from-to)385-389
Number of pages5
JournalGastrointestinal Endoscopy
Volume60
Issue number3
DOIs
StatePublished - Sep 2004
Externally publishedYes

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Endoscopic Ultrasound-Guided Fine Needle Aspiration
Pancreatitis
Needles
Gastrointestinal Endoscopy
Postal Service
Pulmonary Embolism
Cause of Death

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Eloubeidi, M. A., Gress, F. G., Savides, T. J., Wiersema, M. J., Kochman, M. L., Ahmad, N. A., ... Mel Wilcox, C. (2004). Acute pancreatitis after EUS-guided FNA of solid pancreatic masses: A pooled analysis from EUS centers in the United States. Gastrointestinal Endoscopy, 60(3), 385-389. https://doi.org/10.1016/S0016-5107(04)01714-6

Acute pancreatitis after EUS-guided FNA of solid pancreatic masses : A pooled analysis from EUS centers in the United States. / Eloubeidi, Mohamad A.; Gress, Frank G.; Savides, Thomas J.; Wiersema, Maurits J.; Kochman, Michael L.; Ahmad, Nuzhat A.; Ginsberg, Gregory G.; Erickson, Richard A.; DeWitt, John; Van Dam, Jacques; Nickl, Nicholas J.; Levy, Michael J.; Clain, Jonathan E.; Chak, Amitabh; Sivak, Michael V.; Wong, Richard; Isenberg, Gerard; Scheiman, James M.; Bounds, Brenna; Kimmey, Michael B.; Saunders, Michael D.; Chang, Kenneth J.; Sharma, Ashish; Nguyen, Phoniex; Lee, John G.; Edmundowicz, Steven A.; Early, Dayna; Azar, Riad; Etemad, Babak; Chen, Yang K.; Waxman, Irving; Shami, Vanessa; Catalano, Mark F.; Mel Wilcox, C.

In: Gastrointestinal Endoscopy, Vol. 60, No. 3, 09.2004, p. 385-389.

Research output: Contribution to journalArticle

Eloubeidi, MA, Gress, FG, Savides, TJ, Wiersema, MJ, Kochman, ML, Ahmad, NA, Ginsberg, GG, Erickson, RA, DeWitt, J, Van Dam, J, Nickl, NJ, Levy, MJ, Clain, JE, Chak, A, Sivak, MV, Wong, R, Isenberg, G, Scheiman, JM, Bounds, B, Kimmey, MB, Saunders, MD, Chang, KJ, Sharma, A, Nguyen, P, Lee, JG, Edmundowicz, SA, Early, D, Azar, R, Etemad, B, Chen, YK, Waxman, I, Shami, V, Catalano, MF & Mel Wilcox, C 2004, 'Acute pancreatitis after EUS-guided FNA of solid pancreatic masses: A pooled analysis from EUS centers in the United States', Gastrointestinal Endoscopy, vol. 60, no. 3, pp. 385-389. https://doi.org/10.1016/S0016-5107(04)01714-6
Eloubeidi, Mohamad A. ; Gress, Frank G. ; Savides, Thomas J. ; Wiersema, Maurits J. ; Kochman, Michael L. ; Ahmad, Nuzhat A. ; Ginsberg, Gregory G. ; Erickson, Richard A. ; DeWitt, John ; Van Dam, Jacques ; Nickl, Nicholas J. ; Levy, Michael J. ; Clain, Jonathan E. ; Chak, Amitabh ; Sivak, Michael V. ; Wong, Richard ; Isenberg, Gerard ; Scheiman, James M. ; Bounds, Brenna ; Kimmey, Michael B. ; Saunders, Michael D. ; Chang, Kenneth J. ; Sharma, Ashish ; Nguyen, Phoniex ; Lee, John G. ; Edmundowicz, Steven A. ; Early, Dayna ; Azar, Riad ; Etemad, Babak ; Chen, Yang K. ; Waxman, Irving ; Shami, Vanessa ; Catalano, Mark F. ; Mel Wilcox, C. / Acute pancreatitis after EUS-guided FNA of solid pancreatic masses : A pooled analysis from EUS centers in the United States. In: Gastrointestinal Endoscopy. 2004 ; Vol. 60, No. 3. pp. 385-389.
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title = "Acute pancreatitis after EUS-guided FNA of solid pancreatic masses: A pooled analysis from EUS centers in the United States",
abstract = "Background The aim of this study was to determine the frequency and the severity of pancreatitis after EUS-guided FNA of solid pancreatic masses. A survey of centers that offer training in EUS in the United States was conducted. Methods A list of centers in which training in EUS is offered was obtained from the Web site of the American Society for Gastrointestinal Endoscopy. Designated program directors were contacted via e-mail. The information requested included the number of EUS-guided FNA procedures performed for solid pancreatic masses, the number of cases of post-procedure pancreatitis, and the method for tracking complications. For each episode of pancreatitis, technical details were obtained about the procedure, including the location of the mass, the type of fine needle used, the number of needle passes, and the nature of the lesion. Results Nineteen of the 27 programs contacted returned the questionnaire (70{\%}). In total, 4909 EUS-guided FNAs of solid pancreatic masses were performed in these 19 centers over a mean of 4 years (range 11 months to 9 years). Pancreatitis occurred after 14 (0.29{\%}): 95{\%} CI[0.16, 0.48] procedures. At two centers in which data on complications were prospectively collected, the frequency of acute pancreatitis was 0.64{\%}, suggesting that the frequency of pancreatitis in the retrospective cohort (0.26{\%}) was under-reported (p=0.22). The odds that cases of pancreatitis would be reported were 2.45 greater for the prospective compared with the retrospective cohort (95{\%} CI[0.55, 10.98]). The median duration of hospitalization for treatment of pancreatitis was 3 days (range 1-21 days). The pancreatitis was classified as mild in 10 cases, moderate in 3, and severe in one; one death (proximate cause, pulmonary embolism) occurred after the development of pancreatitis in a patient with multiple comorbid conditions. Conclusions EUS-guided FNA of solid pancreatic masses is infrequently associated with acute pancreatitis. The procedure appears to be safe when performed by experienced endosonographers. The frequency of post EUS-guided FNA pancreatitis may be underestimated by retrospective analysis.",
author = "Eloubeidi, {Mohamad A.} and Gress, {Frank G.} and Savides, {Thomas J.} and Wiersema, {Maurits J.} and Kochman, {Michael L.} and Ahmad, {Nuzhat A.} and Ginsberg, {Gregory G.} and Erickson, {Richard A.} and John DeWitt and {Van Dam}, Jacques and Nickl, {Nicholas J.} and Levy, {Michael J.} and Clain, {Jonathan E.} and Amitabh Chak and Sivak, {Michael V.} and Richard Wong and Gerard Isenberg and Scheiman, {James M.} and Brenna Bounds and Kimmey, {Michael B.} and Saunders, {Michael D.} and Chang, {Kenneth J.} and Ashish Sharma and Phoniex Nguyen and Lee, {John G.} and Edmundowicz, {Steven A.} and Dayna Early and Riad Azar and Babak Etemad and Chen, {Yang K.} and Irving Waxman and Vanessa Shami and Catalano, {Mark F.} and {Mel Wilcox}, C.",
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TY - JOUR

T1 - Acute pancreatitis after EUS-guided FNA of solid pancreatic masses

T2 - A pooled analysis from EUS centers in the United States

AU - Eloubeidi, Mohamad A.

AU - Gress, Frank G.

AU - Savides, Thomas J.

AU - Wiersema, Maurits J.

AU - Kochman, Michael L.

AU - Ahmad, Nuzhat A.

AU - Ginsberg, Gregory G.

AU - Erickson, Richard A.

AU - DeWitt, John

AU - Van Dam, Jacques

AU - Nickl, Nicholas J.

AU - Levy, Michael J.

AU - Clain, Jonathan E.

AU - Chak, Amitabh

AU - Sivak, Michael V.

AU - Wong, Richard

AU - Isenberg, Gerard

AU - Scheiman, James M.

AU - Bounds, Brenna

AU - Kimmey, Michael B.

AU - Saunders, Michael D.

AU - Chang, Kenneth J.

AU - Sharma, Ashish

AU - Nguyen, Phoniex

AU - Lee, John G.

AU - Edmundowicz, Steven A.

AU - Early, Dayna

AU - Azar, Riad

AU - Etemad, Babak

AU - Chen, Yang K.

AU - Waxman, Irving

AU - Shami, Vanessa

AU - Catalano, Mark F.

AU - Mel Wilcox, C.

PY - 2004/9

Y1 - 2004/9

N2 - Background The aim of this study was to determine the frequency and the severity of pancreatitis after EUS-guided FNA of solid pancreatic masses. A survey of centers that offer training in EUS in the United States was conducted. Methods A list of centers in which training in EUS is offered was obtained from the Web site of the American Society for Gastrointestinal Endoscopy. Designated program directors were contacted via e-mail. The information requested included the number of EUS-guided FNA procedures performed for solid pancreatic masses, the number of cases of post-procedure pancreatitis, and the method for tracking complications. For each episode of pancreatitis, technical details were obtained about the procedure, including the location of the mass, the type of fine needle used, the number of needle passes, and the nature of the lesion. Results Nineteen of the 27 programs contacted returned the questionnaire (70%). In total, 4909 EUS-guided FNAs of solid pancreatic masses were performed in these 19 centers over a mean of 4 years (range 11 months to 9 years). Pancreatitis occurred after 14 (0.29%): 95% CI[0.16, 0.48] procedures. At two centers in which data on complications were prospectively collected, the frequency of acute pancreatitis was 0.64%, suggesting that the frequency of pancreatitis in the retrospective cohort (0.26%) was under-reported (p=0.22). The odds that cases of pancreatitis would be reported were 2.45 greater for the prospective compared with the retrospective cohort (95% CI[0.55, 10.98]). The median duration of hospitalization for treatment of pancreatitis was 3 days (range 1-21 days). The pancreatitis was classified as mild in 10 cases, moderate in 3, and severe in one; one death (proximate cause, pulmonary embolism) occurred after the development of pancreatitis in a patient with multiple comorbid conditions. Conclusions EUS-guided FNA of solid pancreatic masses is infrequently associated with acute pancreatitis. The procedure appears to be safe when performed by experienced endosonographers. The frequency of post EUS-guided FNA pancreatitis may be underestimated by retrospective analysis.

AB - Background The aim of this study was to determine the frequency and the severity of pancreatitis after EUS-guided FNA of solid pancreatic masses. A survey of centers that offer training in EUS in the United States was conducted. Methods A list of centers in which training in EUS is offered was obtained from the Web site of the American Society for Gastrointestinal Endoscopy. Designated program directors were contacted via e-mail. The information requested included the number of EUS-guided FNA procedures performed for solid pancreatic masses, the number of cases of post-procedure pancreatitis, and the method for tracking complications. For each episode of pancreatitis, technical details were obtained about the procedure, including the location of the mass, the type of fine needle used, the number of needle passes, and the nature of the lesion. Results Nineteen of the 27 programs contacted returned the questionnaire (70%). In total, 4909 EUS-guided FNAs of solid pancreatic masses were performed in these 19 centers over a mean of 4 years (range 11 months to 9 years). Pancreatitis occurred after 14 (0.29%): 95% CI[0.16, 0.48] procedures. At two centers in which data on complications were prospectively collected, the frequency of acute pancreatitis was 0.64%, suggesting that the frequency of pancreatitis in the retrospective cohort (0.26%) was under-reported (p=0.22). The odds that cases of pancreatitis would be reported were 2.45 greater for the prospective compared with the retrospective cohort (95% CI[0.55, 10.98]). The median duration of hospitalization for treatment of pancreatitis was 3 days (range 1-21 days). The pancreatitis was classified as mild in 10 cases, moderate in 3, and severe in one; one death (proximate cause, pulmonary embolism) occurred after the development of pancreatitis in a patient with multiple comorbid conditions. Conclusions EUS-guided FNA of solid pancreatic masses is infrequently associated with acute pancreatitis. The procedure appears to be safe when performed by experienced endosonographers. The frequency of post EUS-guided FNA pancreatitis may be underestimated by retrospective analysis.

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