Antibiotics Do Not Decrease the Rate of Infection After Endoscopic Ultrasound Fine-Needle Aspiration of Pancreatic Cysts

Facciorusso, Antonio; Buccino, Vincenzo Rosario; Turco, Antonio; Antonino, Matteo; Muscatiello, Nicola

doi:10.1007/s10620-019-05655-x

Cited by 22 publications

(38 citation statements)

References 23 publications

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“…Among the 226 patients randomized, only 1 patient (in the placebo group) developed an infection (0.87%), while the incidence of infections did not differ significantly with or without ciprofloxacin prophylaxis. This finding is in line with the results reported in previous retrospective studies, all of which confirmed that antibiotic prophylaxis is not necessary [ 28 - 31 ]. In light of this emerging evidence, forthcoming guidelines should perhaps reappraise this particular statement.…”

Section: Qis In the Pre-procedures Phasesupporting

confidence: 93%

Quality in pancreatic endoscopic ultrasound: what’s new in 2020?

Papanikolaou

Tziatzios

Gkolfakis

et al. 2020

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Quality assessment and improvement of an endoscopic service has emerged as a basic component of everyday gastrointestinal endoscopy. In order to ensure a high level of quality, a series of actions must be adopted when performing an endoscopic examination. Nonetheless, quality still remains a qualitative parameter; thus, implementation of specific indicators of quality is warranted. Irrespective of the nature of the endoscopic procedure, quality indicators usually refer to either structural properties of an endoscopy unit (e.g., examination availability), procedural factors (e.g., diagnostic accuracy), or patient outcomes (e.g., occurrence of an adverse event related to performance of an endoscopic procedure). Moreover, they are usually classified into 3 distinct sections, according to the phase of the procedure they relate to: i.e., before, during, and after the examination. The aim of this review is to present measures that need to be adopted in order to reach an optimal quality level during an endoscopic ultrasound examination and to provide up-to-date data regarding the respective quality indicators implicated.

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Section: Qis In the Pre-procedures Phasesupporting

confidence: 93%

Quality in pancreatic endoscopic ultrasound: what’s new in 2020?

Papanikolaou

Tziatzios

Gkolfakis

et al. 2020

aog

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“…The technique used for diagnostic and interventional EUS at our center has been described elsewhere [ 20 , 21 , 22 , 23 , 24 ].…”

Section: Methodsmentioning

confidence: 99%

Contrast-Enhanced Harmonic Endoscopic Ultrasound-Guided Fine-Needle Aspiration versus Standard Fine-Needle Aspiration in Pancreatic Masses: A Propensity Score Analysis

et al. 2020

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Background: Whether endoscopic ultrasound (EUS) contrast-enhanced fine-needle aspiration (CH-EUS-FNA) determines superior results in comparison to standard EUS-FNA in tissue acquisition of pancreatic masses remains unclear. The aim of this study was to compare these two techniques on a series of patients with solid pancreatic lesions. Methods: 362 patients underwent EUS-FNA (2008–2019), after the propensity score matching of two groups were compared; 103 treated with CH-EUS-FNA (group 1) and 103 with standard EUS-FNA (group 2). The primary outcome was the diagnostic accuracy. Secondary outcomes were sensitivity, specificity, and sample adequacy. Results: Diagnostic sensitivity was 87.6% in group 1 and 80% in group 2 (p = 0.18). The negative predictive value was 56% in group 1 and 41.5% in group 2 (p = 0.06). The specificity and positive predictive values were 100% for both groups. Diagnostic accuracy was 89.3% and 82.5%, respectively (p = 0.40). Sample adequacy was 94.1% in group 1 and 91.2% in group 2 (p = 0.42). The rate of adequate core histologic samples was 33% and 28.1%, respectively (p = 0.44), and the number of needle passes to obtain adequate samples were 2.4 ± 0.6 and 2.7 ± 0.8, respectively (p = 0.76). These findings were confirmed in subgroup analyses, conducted according to lesion size and contrast enhancement pattern. Conclusions: CH-EUS-FNA does not appear to be superior to standard EUS-FNA in patients with pancreatic masses.

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“…Patients in antithrombotic treatment suspended the anticoagulant/antiaggregant agent and underwent bridging therapy with enoxaparin when necessary. No intravenous prophylactic antibiotics before EUS-guided tissue sampling or EUS-CPN were administered as described elsewhere [ 20 , 21 ].…”

Section: Methodsmentioning

confidence: 99%

“…The technique used for diagnostic and interventional EUS at our center has been described elsewhere [ 16 , 17 , 20 , 22 , 23 ].…”

Section: Methodsmentioning

confidence: 99%

Efficacy and Safety of Non-Anesthesiologist Administration of Propofol Sedation in Endoscopic Ultrasound: A Propensity Score Analysis

et al. 2020

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In spite of promising preliminary results, evidence supporting the use of non-anesthesiologist-administered propofol sedation (NAAP) in endoscopic ultrasound (EUS) procedures is still limited. The aim of this manuscript was to examine the safety and efficacy of NAAP as compared to anesthesiologist-administered propofol sedation in EUS procedures performed in a referral center. Out of 832 patients referred to our center between 2016 and 2019, after propensity score matching two groups were compared: 305 treated with NAAP and 305 controls who underwent anesthesiologist-administered propofol sedation. The primary outcome was the rate of major complications. The median age was 67 years and the proportion of patients with comorbidities was 31.8% in both groups. One patient in each group (0.3%) experienced a major complication, whereas minor complications were observed in 13 patients in the NAAP group (4.2%) and 10 patients in the control group (3.2%; p = 0.52). Overall pain during the procedure was 2.3 ± 1 in group 1 and 1.8 ± 1 in group 2 (p = 0.67), whereas pain/discomfort upon awakening was rated as 1 ± 0.5 in both groups (p = 0.72). NAAP is safe and effective even in advanced EUS procedures. Further randomized-controlled trials (RCTs) are warranted to confirm these findings.

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Antibiotics Do Not Decrease the Rate of Infection After Endoscopic Ultrasound Fine-Needle Aspiration of Pancreatic Cysts

Cited by 22 publications

References 23 publications

Quality in pancreatic endoscopic ultrasound: what’s new in 2020?

Quality in pancreatic endoscopic ultrasound: what’s new in 2020?

Contrast-Enhanced Harmonic Endoscopic Ultrasound-Guided Fine-Needle Aspiration versus Standard Fine-Needle Aspiration in Pancreatic Masses: A Propensity Score Analysis

Efficacy and Safety of Non-Anesthesiologist Administration of Propofol Sedation in Endoscopic Ultrasound: A Propensity Score Analysis

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