Complications of endoscopic ultrasound

Aims The aim of this prospective trial is to show complications of endoscopic ultrasound (EUS) of the upper GI tract. The data on complications of EUS in Southeastern Europe do not exist.

Methods In our study we included all patients who underwent an EUS of the upper part of the GI tract between 01.10.2023. and 30.9.2024. All procedures were performed with the patients under general anesthesia. Patients who had an EUS-Guided Fine-Needle Aspiration (FNA) of a cyst were prescribed antibiotic prophylaxis.We monitored all patients for at least 2 hours after the procedure and those with complications were observed for at least 48 hours after the onset of complications.

Results In the one year period (from 01.10..2023 to 31.9.2024), 799 patients who underwent EUS of the upper GI tract were analyzed. 608 (76.1%) patients underwent diagnostic endosonographic procedures without any intervention. EUS with invasive diagnostic and therapeutic procedures was performed in 191 (23.9%) patients. FNA was performed in 80 (10%) patients, EUS-guided Fine-Needle Biopsy (FNB) was performed in 104 (13%) patients, plastic stent implantation was performed in 2 (0.3%) patients, and lumen-apposing stent implantation (Axios) was performed in 5 (0.6%) patients. Bleeding as a complication occurred in 3 (0.4%) patients (one patient developed a large retroperitoneal hematoma), mild form of acute pancreatitis developed in 2 (0.3%) patients, sepsis developed in 2 (0.3%) patients, cyst inflammation developed in 2 (0.3%) patients and stent migration developed in one (0.1%) patient. The overall mortality of non-interventional and interventional endosonographic procedures was 0.

Conclusions EUS of the upper GI tract is a safe diagnostic and therapeutic technique with rare complications and sometimes with serious complications that are predominantly associated with invasive diagnostic and therapeutic procedures.

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Artikel online veröffentlicht:
27. März 2025