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Endoscopy 2006; 38(11): 1149-1151
DOI: 10.1055/s-2006-944845
Case report
© Georg Thieme Verlag KG Stuttgart · New York

Same-day endoscopic retrograde cholangiopancreatography after transduodenal endoscopic ultrasound-guided needle aspiration: do we need to be cautious?

F.  Di Matteo1 , L.  Shimpi1 , A.  Gabbrielli1 , M.  Martino1 , M.  Caricato2 , A.  Esposito2 , M.  L.  De Cicco3 , R.  Coppola2 , G.  Costamagna1, 4
  • 1 Department of Digestive Diseases, GI Endoscopy Unit, Università Campus Bio-Medico, Rome, Italy
  • 2 Department of Digestive Diseases, Surgery Unit, Università Campus Bio-Medico, Rome, Italy
  • 3 Radiology Unit DEA, “Umberto I” Policlinic of Rome, Italy
  • 4 Department of Surgical Endoscopy, Catholic University, Rome, Italy
Further Information

Publication History

Submitted 18 May 2006

Accepted after revision 12 August 2006

Publication Date:
17 November 2006 (online)

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Patients who are undergoing endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for suspected pancreatic tumors frequently undergo endoscopic retrograde cholangiopancreatography (ERCP) for palliation of their symptoms. Performing EUS-FNA and ERCP in tandem may be cost-effective and may reduce procedure time, but the potential risks associated with this approach have not been clearly defined in the literature. We report two patients who underwent same-day therapeutic ERCP after transduodenal EUS-FNA for pancreatic tumors. Endoscopic biliary manipulation during ERCP aggravated an inadvertent and subclinical needle puncture injury to the bile duct sustained during the preceding EUS-FNA. This resulted in leakage of bile into the retroperitoneal space, and both patients required laparotomy and surgical drainage. Additional clinical evidence is needed to clarify these issues and to determine whether it would be prudent to perform therapeutic ERCP prior to diagnostic transduodenal EUS-FNA when these two procedures are planned as sequential or same-day procedures.

References

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F. Di Matteo, M. D.

Department of Digestive Diseases

GI Endoscopy Unit · Università Campus Bio-Medico · Via Emilio Longoni, 89 · Rome 00155 · Italy

Fax: +39-06-22541520

Email: f.dimatteo@unicampus.it

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