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

Endoscopic Ultrasound Elastography

“…All nodules of chronic pancreatitis presented benign aspects (mixed green and low intensity of blue). Using sonoelastography LN were classified into 1 of 5 scores [1,2,3,4,5]. If we consider scores 1 and 2 as benign and 3–5 as malignant, the sensitivity, specificity, and positive and negative predictive values of EUS sonoelastography in the differentiation of benign from malignant pancreatic masses were 80.6, 92.3, 93.3, and 78.1%, respectively, with a global accuracy of this new technology of 89.2%.…”

“…However, FNA is technically demanding, and multiple punctures of LN or masses are sometimes required to obtain sufficient tissue for histological assessment. The fact that pancreatic masses have a wide differential diagnosis that includes benign and malignant etiologies and FNA of the pancreas is associated with a small, but non-insignificant, risk of pancreatitis deserves further consideration [1]. Hence, the ability to more accurately evaluate masses and LN prior to sampling in an effort to aid in targeting lesions for FNA and possibly reduce complications would be welcomed by echo-endoscopists.…”

Utility of pancreatic duct brushing for diagnosis of pancreatic carcinoma

“…The major complications of EUS-guided FNA are bleeding, pancreatitis, and duodenal perforation. 2,10,11 The frequency of complications is relatively low, 1 but there is a possibility of tumor seeding along the needle biopsy tract into the gastric wall or peritoneum. There is one report of the seeding of cancer cells into the gastric wall after EUS-guided FNA in a patient with pancreatic tail adenocarcinoma.…”

Endoscopic ultrasound-guided fine-needle aspiration of solid pancreatic masses with rapid on-site cytological evaluation by endosonographers without attendance of cytopathologists

“…Since then, EUS-FNA of pancreatic masses has been performed in many institutions and shown to have not only a high diagnostic accuracy (80-90% or more) but also a low rate of complications (0-2.5% for solid pancreatic masses) [2,12,20,[23][24][25][26][27][28][29][30][31][32][33][34][35][36]. Thus, EUS-FNA is regarded today as superior to endoscopic retrograde cholangiopancreatography (ERCP), US-guided biopsy, or computed tomography (CT)-guided biopsy for cytological diagnosis of pancreatic masses [2,12,19,20,[27][28][29].…”