Background: EUS-guided fine-needle aspiration (EUS-FNA) permits both morpho
logic and cytologic analysis of lesions within or adjacent to the GI tract.
Despite increasing use at this technique, the safety and overall complicat
ion rates remain poorly defined.
Methods: During a period of 20 months, 322 consecutive patients underwent E
US-FNA in 2 centers. All procedures were performed with the patients under
general anesthesia. All complications (including local complications result
ing from endoscopy/aspiration or clinical complications after the procedure
) were evaluated. Potential risk factors for the development of complicatio
ns were also analyzed including site and nature of the lesion, presence of
portal hypertension, and number of needle passes.
Results: A total of 345 lesions were aspirated in 322 patients. EUS-FNA inv
olved the pancreas in 248 cases, Pancreatic lesions included solid (134) an
d cystic (114) types, which required a mean of 2.5 and 1.4 needle passes, r
espectively. Complications were observed in 4 (1.2%) patients after aspirat
ion of pancreatic cystic lesions (acute pancreatitis, n = 3; aspiration pne
umonia, n = l)and all cases of pancreatitis resulted from FNA of lesions in
the head/uncinate process. No complications resulted from FNA of solid pan
creatic lesions. Complications were not observed after FNA of lymph nodes (
n = 62) and one case of aspiration pneumonia was observed after FNA of a st
romel tumor, EUS-FNA was performed without complication in 16 patients (5%)
with portal hypertension. The number of needle passes was not predictive o
f complications.
Conclusions: Because the overall risk of complications from EUS-FNA was rel
atively low (1.6%) with no severe or fatal incidents and although the risk
appears slightly higher than that for standard EUS alone, the safety of EUS
-FNA appears acceptable based on this analysis from an experienced center.