The Risk Factors for Acute Pancreatitis after Endoscopic Ultrasound Guided Biopsy.
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.
['Ribeiro|Afonso|A|', 'Goel|Akash|A|']
D015746:Abdominal Pain D000208:Acute Disease D000368:Aged D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration D005260:Female D006801:Humans D016015:Logistic Models D008297:Male D008875:Middle Aged D010179:Pancreas D010195:Pancreatitis D011446:Prospective Studies D012307:Risk Factors D062606:Tertiary Care Centers
Pancreatitis Biopsy Endoscopy