Introduction: Endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) of the pancreas is increasingly being utilized to diagnose pancreatic masses. We have previously reported 2 cases of clinical pancreatitis following EUS guided FNA of the pancreas. Aim of Study: To determine the frequency of chemical and clinical pancreatitis following EUS guided FNA of the pancreas. Methods: All patients having EUS guided FNA biopsy of the pancreas were eligible. Exclusion criteria included: All patients with acute pancreatitis or having ERCP within 48 hours of the EUS FNA. Serum amylase and lipase levels were measured immediately prior to and 2 hours post EUS FNA. Patients were called 24-72 hours after FNA to follow up for increased pain, nausea, or vomiting suggesting clinical pancreatitis. Results: Data was prospectively collected on 36 patients. Pre- and post-FNA amylase and lipase levels were available for all patients. Ten patients had a past history of pancreatitis prior to the EUS FNA. Pre and Post EUS Guided FNA Serum Enzyme Levels Mean Pre Mean Post Mean Change CI P Value Amylase 70.0 75.0 5.0 -31.4, 20.2 .47 Lipase 315.0 547.6 232.0 -458.9, -6.05 .044 CI = Confidence Interval As a group, there was a mean increase in serum amylase and lipase levels. When matched pair analysis was performed, the differences were not statistically significant for amylase levels but were for lipase (p<0,05) suggesting that lipase may be a more sensitive marker. There were no episodes of clinical pancreatitis. The lipase levels were elevated the most in 60% (6/10) of patients with a past history of pancreatitis. Conclusion: This prospective study found no evidence of clinical pancreatitis. Patients with a prior history of pancreatitis had higher amylase and lipase levels than those who did not suggesting this as a possible risk factor. Based on this prospective study, further investigations are warranted to evaluate the true risk of pancreatitis from this procedure.
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging