Korean J Gastroenterol.  2018 Sep;72(3):135-140. 10.4166/kjg.2018.72.3.135.

The Risk Factors for Acute Pancreatitis after Endoscopic Ultrasound Guided Biopsy

• Ribeiro A
• Goel A

• KMID: 2420751
• DOI: http://doi.org/10.4166/kjg.2018.72.3.135

Abstract

BACKGROUND/AIMS
The risk of developing pancreatitis induced by endoscopic ultrasound-guided fine needle aspiration (EUS FNA) is relatively small. However, patients undergoing sampling through the normal pancreatic parenchyma or the pancreatic duct may have a higher rate of pancreatitis. Here, we determine the factors associated with increased risk of acute pancreatitis in patients undergoing FNA through normal pancreatic parenchyma/pancreatic duct.
METHODS
In this prospective study at a tertiary cancer center, patients undergoing sampling through the pancreatic duct or ≥5 mm of the normal parenchyma between December 2013 and September 2017 were included. Post-EUS induced pancreatitis was diagnosed by the presence of abdominal pain with an amylase or lipase level higher than three times normal value.
RESULTS
A total of 712 patients underwent pancreatic EUS FNA. A total of 163 patients were included in the high-risk group. Mean age was 63 years, 82 females, mean number of needle-passes was 3.3 (range, 1-7). Fifteen patients (15/163, 9.2%) developed pancreatitis after EUS FNA through the pancreatic parenchyma compared with only one case among the control group (<5 mm of normal parenchyma) (0.18%, 1/549, p<0.0001). Several factors appeared to be associated with pancreatitis, including young age, solid lesion, and a recent history of acute pancreatitis. By logistic regression, a prior history of recent pancreatitis was the only statistically significant factor associated with post-EUS-guided biopsy pancreatitis (p=0.008).
CONCLUSIONS
Patients with a recent history of acute pancreatitis undergoing EUS FNA through 5 mm or more of the normal pancreatic parenchyma are at a much greater risk of acute pancreatitis.

Keyword

Pancreatitis; Biopsy; Endoscopy

MeSH Terms

Abdominal Pain
Amylases
Biopsy*
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Endoscopy
Female
Humans
Lipase
Logistic Models
Pancreatic Ducts
Pancreatitis*
Prospective Studies
Reference Values
Risk Factors*
Ultrasonography*
Amylases
Lipase

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