The Risk Factors for Acute Pancreatitis after Endoscopic Ultrasound Guided Biopsy.
10.4166/kjg.2018.72.3.135
- Author:
Afonso RIBEIRO
1
;
Akash GOEL
Author Information
1. Division of Gastroenterology, Palmetto General Hospital, Hialeah, FL, USA. eusgidoc@gmail.com
- Publication Type:Original Article
- Keywords:
Pancreatitis;
Biopsy;
Endoscopy
- MeSH:
Abdominal Pain;
Amylases;
Biopsy*;
Endoscopic Ultrasound-Guided Fine Needle Aspiration;
Endoscopy;
Female;
Humans;
Lipase;
Logistic Models;
Pancreatic Ducts;
Pancreatitis*;
Prospective Studies;
Reference Values;
Risk Factors*;
Ultrasonography*
- From:The Korean Journal of Gastroenterology
2018;72(3):135-140
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: The risk of developing pancreatitis induced by endoscopic ultrasound-guided fine needle aspiration (EUS FNA) is relatively small. However, patients undergoing sampling through the normal pancreatic parenchyma or the pancreatic duct may have a higher rate of pancreatitis. Here, we determine the factors associated with increased risk of acute pancreatitis in patients undergoing FNA through normal pancreatic parenchyma/pancreatic duct. METHODS: In this prospective study at a tertiary cancer center, patients undergoing sampling through the pancreatic duct or ≥5 mm of the normal parenchyma between December 2013 and September 2017 were included. Post-EUS induced pancreatitis was diagnosed by the presence of abdominal pain with an amylase or lipase level higher than three times normal value. RESULTS: A total of 712 patients underwent pancreatic EUS FNA. A total of 163 patients were included in the high-risk group. Mean age was 63 years, 82 females, mean number of needle-passes was 3.3 (range, 1–7). Fifteen patients (15/163, 9.2%) developed pancreatitis after EUS FNA through the pancreatic parenchyma compared with only one case among the control group (<5 mm of normal parenchyma) (0.18%, 1/549, p<0.0001). Several factors appeared to be associated with pancreatitis, including young age, solid lesion, and a recent history of acute pancreatitis. By logistic regression, a prior history of recent pancreatitis was the only statistically significant factor associated with post-EUS-guided biopsy pancreatitis (p=0.008). CONCLUSIONS: Patients with a recent history of acute pancreatitis undergoing EUS FNA through 5 mm or more of the normal pancreatic parenchyma are at a much greater risk of acute pancreatitis.
