EUS-guided fine-needle aspiration of the pancreas: Evaluation of pancreatitis as a complication

Gress, Frank G.; Michael, Hazar; Gelrud, Daniel; Patel, Panjak; Gottlieb, Klaus; Singh, Frank; Grendell, James H.

doi:10.1067/mge.2002.129602

Cited by 33 publications

(22 citation statements)

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“…This allows for high-resolution imaging of the five histologic layers of the gastrointestinal wall and the surrounding structures, including the pancreas. Given the minimal invasiveness and low complication rate of the procedure, which are similar to those of standard endoscopy for patients who do not undergo FNA, 34 as well as an overall complication rate of 1.6% to 2% 35,36 when FNA is performed, EUS and EUS-guided FNA have become attractive, highly accurate, and safe procedures in the diagnosis and treatment of many gastrointestinal diseases.…”

Section: Eus As a Screening Tool For Pancreatic Cancermentioning

confidence: 97%

Early Detection of Pancreatic Cancer: Why, who, and how to Screen

Klapman

Malafa

2008

Cancer Control

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Section: Eus As a Screening Tool For Pancreatic Cancermentioning

confidence: 97%

Early Detection of Pancreatic Cancer: Why, who, and how to Screen

Klapman

Malafa

2008

Cancer Control

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“…157,158 Mild or moderate acute pancreatitis has been described, especially when EUS-FNA of the pancreas is performed in patients with benign pancreatic diseases. [159][160][161] Tumor cell seeding has been reported in only 2 cases. 162,163 EUS-FNA has a lower risk of peritoneal contamination with malignancy than CT-guided FNA (2.2% versus 16.3%), respectively.…”

Section: Eus-fnamentioning

confidence: 99%

Role of endoscopic ultrasound in the diagnosis and staging of pancreatic cancer

Săftoiu

Vilmann

2008

J of Clinical Ultrasound

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Early diagnosis of pancreatic cancer remains a difficult task, and multiple imaging tests have been proposed over the years. The aim of this review is to describe the current role of endoscopic ultrasound (EUS) for the diagnosis and staging of patients with pancreatic cancer. A detailed search of MEDLINE between 1980 and 2007 was performed using the following keywords: pancreatic cancer, endoscopic ultrasound, diagnosis, and staging. References of the selected articles were also browsed and consulted. Despite progress made with other imaging methods, EUS is still considered to be superior for the detection of clinically suspected lesions, especially if the results of other cross-sectional imaging modalities are equivocal. The major advantage of EUS is the high negative predictive value that approaches 100%, indicating that the absence of a focal mass reliably excludes pancreatic cancer. The introduction of EUS-guided fine needle aspiration allows a preoperative diagnosis in patients with resectable cancer, as well as a confirmation of diagnosis before chemoradiotherapy for those that are not. This comprehensive review highlighted the diagnostic capabilities of EUS including the newest refinements such as contrast-enhanced EUS, EUS elastography, and 3-dimensional EUS. The place of EUSguided biopsy is also emphasized, including the addition of molecular marker techniques.

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“…Also EUS-FNA of pancreatic lesions can be considered a safe technique, especially if several technical points are taken into account in each specific situation the endosonographer perform a FNA [118] . The two major complications after a FNA are pancreatitis (0%-2%) [119,120] and bleeding (0% to 1.3%) [121,122] , while the risk of infection exists only when mucinous cystic lesions are involved [118] . No deaths were reported [120][121][122][123] .…”

Section: Screeningmentioning

confidence: 99%

“…The two major complications after a FNA are pancreatitis (0%-2%) [119,120] and bleeding (0% to 1.3%) [121,122] , while the risk of infection exists only when mucinous cystic lesions are involved [118] . No deaths were reported [120][121][122][123] . Actually, the diagnosis of PanINs by imaging tests is very challenging.…”

Section: Screeningmentioning

confidence: 99%

Endoscopic ultrasonography for surveillance of individuals at high risk for pancreatic cancer

Lami

Biagini

Galli

2014

WJGE

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Pancreatic cancer is a highly lethal disease with a genetic susceptibility and familial aggregation found in 3%-16% of patients. Early diagnosis remains the only hope for curative treatment and improvement of prognosis. This can be reached by the implementation of an intensive screening program, actually recommended for individuals at high-risk for pancreatic cancer development. The aim of this strategy is to identify premalignant precursors or asymptomatic pancreatic cancer lesions, curable by surgery. Endoscopic ultrasound (EUS) with or without fine needle aspiration (FNA) seems to be the most promising technique for early detection of pancreatic cancer. It has been described as a highly sensitive and accurate tool, especially for small and cystic lesions. Pancreatic intraepithelial neoplasia, a precursor lesion which is highly represented in highrisk individuals, seems to have characteristics chronic pancreatitis-like changes well detected by EUS. Many screening protocols have demonstrated high diagnostic yields for pancreatic pre-malignant lesions, allowing prophylactic pancreatectomies. However, it shows a high interobserver variety even among experienced endosonographers and a low sensitivity in case of chronic pancreatitis. Some new techniques such as contrast-enhanced harmonic EUS, computer-aided diagnostic techniques, confocal laser endomicroscopy miniprobe and the detection of DNA abnormalities or protein markers by FNA, promise improvement of the diagnostic yield of EUS. As the resolution of imaging improves and as our knowledge of precursor lesions grows, we believe that EUS could become the most suitable method to detect curable pancreatic neoplasms in correctly identified asymptomatic at-risk patients.© 2014 Baishideng Publishing Group Inc. All rights reserved. Key words: Endoscopic ultrasonography; Pancreatic cancer; SurveillanceCore tip: In the era of early diagnosis and screening programs, endoscopic ultrasound (EUS) represents the most promising tool able to identify pancreatic precursor neoplasms in high risk individuals. If compared to other imaging techniques, it is highly accurate to diagnose small pancreatic cancer and pre-malignant lesions, with very low rate of complications and limitations. Here are reported the current role of EUS in various international screening programs and its future possible developments.

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EUS-guided fine-needle aspiration of the pancreas: Evaluation of pancreatitis as a complication

Cited by 33 publications

References 0 publications

Early Detection of Pancreatic Cancer: Why, who, and how to Screen

Early Detection of Pancreatic Cancer: Why, who, and how to Screen

Role of endoscopic ultrasound in the diagnosis and staging of pancreatic cancer

Endoscopic ultrasonography for surveillance of individuals at high risk for pancreatic cancer

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