Complication incidence after EUS-guided Fine Needle Biopsy – a single-center experience

Aims Endoscopic ultrasound-guided tissue acquisition, including both fine needle aspiration (EUS-FNA) and fine needle biopsy (EUS-FNB), has been widely used to obtain samples from pancreatic and non-pancreatic lesions. We conducted this study, aiming to summarize the incidence of complications from this procedure in a single endoscopic center.

Methods Data were retrospectively collected from patients who had undergone a diagnostic endoscopic ultrasound (EUS) at our endoscopic center for a 1 year period. We enrolled 87 cases with solid pancreatic or non-pancreatic lesions. All investigations were performed using the Olympus GF-UCT 180 linear echoendoscope and the Hitachi Aloka 750 ultrasound system. A three-prong 22-gauge FNB needle was used in all cases [1] [2].

Results A total of 87 EUS-FNBs were performed on 87 patients. Of them, 43 (49%) were female. The mean age of the subjects was 67.8±12.7 years. Complications were observed in 7 (8%). These included: bleeding in 3 (3.4%), perforation in 3 (3.4%), infection in 1 (1.1%), and pancreatitis in 1 (1.1%). Interestingly, a trend towards more frequent bleeding and pancreatitis was found when the pancreas was the target of FNB (OR 9.98 (95% CI 0.51-191.9)), and perforation was more frequently diagnosed after the procedure when another organ was punctured (OR 5.89 (95% CI 0.29-117.9)). This observation, however, did not reach statistical significance.

Conclusions Overall, the incidence of adverse events (AE) after EUS-FNB in our study is higher than that reported in the literature. Our more frequent perforations could be attributed to operator inexperience and patients` older age. Hemorrhage could be explained by the same needle size used in all cases. In some of them, the needle diameter could be inappropriately larger. Blood thinner agents are proved risk factors for hemorrhage but they were stopped in all patients prior to the procedure. We observed different types of complications according to the targeted organ. The proximity of large blood vessels, surrounding the pancreas, can lead to postprocedural bleeding. Pancreatitis is an obvious complication when the organ is punctured. On the other hand, the fact that perforations are more common when non-pancreatic organs are punctured is probably related not to the biopsy itself but to the rigidity of the echoendoscope and the looseness of the duodenum when it is not affected by pancreatic disorders.

Publikationsverlauf

Artikel online veröffentlicht:
27. März 2025

• References

• 1 Mizuide M, Ryozawa S, Fujita A, Ogawa T, Katsuda H, Suzuki M, Noguchi T, Tanisaka Y.. Complications of Endoscopic Ultrasound-Guided Fine Needle Aspiration: A Narrative Review. Diagnostics (Basel) 2020; 10 (11): 964 PMID: 33213103; PMCID: PMC7698484
• 2 Adverse events associated with EUS and EUS-guided procedures Crossref DOI link: https://doi.org/10.1016/j.gie.2021.09.009