Adverse events of endoscopic ultrasound‐guided fine‐needle aspiration for histologic diagnosis in Japanese tertiary centers: Multicenter retrospective study

Abstract

Background and Aims Endoscopic ultrasound‐guided fine‐needle aspiration (EUS‐FNA) is used for the histopathological diagnosis of any type of gastrointestinal disease. Few adverse events are experienced with this procedure; however, the actual rate of adverse events remains unclear. This study aimed to clarify the current status of cases that experienced adverse events related to the EUS‐FNA procedure used for histopathologic diagnoses. Methods A retrospective analysis of cases with EUS‐FNA‐related adverse events in Japanese tertiary centers was conducted by assessing the following clinical data: basic case information, FNA technique, type of procedural adverse events, and prognosis. Results Of the 13,566 EUS‐FNA cases overall, the total number of cases in which adverse events related to EUS‐FNA occurred was 234. The incidence of EUS‐FNA‐related adverse events was ~1.7%. Bleeding and pancreatitis cases accounted for ~49.1% and 26.5% of all adverse events, respectively. Bleeding was the most common adverse event with only seven cases requiring blood transfusion. In cases with neuroendocrine tumors, pancreatitis was the most frequent adverse event. Needle tract seeding because of EUS‐FNA was observed during the follow‐up period in only ~0.1% of cases with pancreatic cancer. There was no mortality because of adverse events caused by EUS‐FNA. Conclusions This study revealed that the adverse events‐related EUS‐FNA for histopathologic diagnoses were not severe conditions, and had low incidence.

Evaluation of preoperative diagnostic methods for resectable pancreatic cancer: a diagnostic capability and impact on the prognosis of endoscopic ultrasound-guided fine needle aspiration

“…In addition, recently, new needles with unique tip shapes have been utilized in fine needle biopsy (FNB) and have shown higher diagnostic yield with fewer needle passes [25][26][27]. Previously, rapid onsite evaluation (ROSE) has been considered to be effective in improve the diagnostic ability of EUS-FNA, but a recent study could not find any advantages in the diagnostic capability of ROSE during EUS-FNB for pancreatic cancer [28], although ROSE during ERCP-guided brushing for biliary strictures could still be an effective method [29].The overall incidence rate of FNA-related adverse events, such as bleeding, pancreatitis, and peritonitis, has been reported to be very low at 1-2%, and most could be managed conservatively [7,30]. Considering its diagnostic ability and safety, EUS-FNA could be the first-line endoscopic procedure for the preoperative evaluation of suspected pancreatic cancer.…”

“…The diagnostic capabilities for malignancy of EUS-FNA were considered to be very high for pancreatic cancer, which was reported to have a sensitivity of 0.85-0.89 and specificity of 0.96-0.98 in meta-analyses [4][5][6]. The adverse event rate of EUS-FNA was reported to be 1.7% [7]. Therefore, it is considered a safe procedure.…”

Automatic Segmentation of Pancreatic Tumors Using Deep Learning on a Video Image of Contrast-Enhanced Endoscopic Ultrasound

“…The recent development of newly designed fine needle biopsy needles has further improved sample acquisition rates, with improved diagnostic accuracy [7][8][9][10][11][12]. While EUS-FNA is considered a safe procedure, it still has a possibility of false-negative results and the risk of adverse complications such as bleeding or pancreatitis due to needle puncture [13]. Moreover, needle tract seeding was reported in patients who underwent EUS-FNA for pancreatic cancer [14,15].…”

Establishment of organoids using residual samples from saline flushes during endoscopic ultrasound-guided fine-needle aspiration in patients with pancreatic cancer

“…If researchers use aliquots of tissue samples for organoid creation, it may negatively affect the pathological and genetic diagnosis by significantly reducing the amount of remaining samples. An additional puncture for organoid establishment may pose an increased risk of adverse events (AEs), such as bleeding and tumor seeding 23 24 . To establish a less invasive method of creating organoids from a patient’s tumor, we examined whether PC organoids can be established using the residual samples from saline flushes (RSSFs) during EUS-FNA procedures.…”