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Endoscopy 2007; 39(8): 720-724
DOI: 10.1055/s-2007-966719
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Incidence and clinical significance of hyperamylasemia after endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreatic lesions: a prospective and controlled study

G.  Fernández-Esparrach1 , A.  Ginès1 , P.  García1 , M.  Pellisé1 , M.  Solé2 , P.  Cortés1 , A.  Z.  Gimeno-García1 , O.  Sendino1 , S.  Navarro1 , J.  Llach1 , J.  M.  Bordas1 , A.  Castells1
  • 1Endoscopy Unit, Institut de Malalties Digestives, Hospital Clinic, CIBER_EHD, University of Barcelona, Spain
  • 2Pathology Department, Hospital Clinic, University of Barcelona, Spain
Further Information

Publication History

eingereicht 6 September 2006

akzeptiert 12 June 2007

Publication Date:
30 July 2007 (online)

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Commentaire de travail de G. Fernández-Esparrach et al., pp. 720Endoscopy 2007; 39(08): 846-846
DOI: 10.1055/s-0032-1308861

Background and study aim: Acute pancreatitis as a complication of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreatic lesions is rarely observed. However, there is little information on the incidence of hyperamylasemia after EUS-FNA of the pancreas and its clinical significance. This study aimed to supply this lack of information.

Patients and methods: Patients who underwent EUS-FNA of a pancreatic lesion between October 2004 and October 2005 were studied prospectively. Exclusion criteria were: (i) platelet count under 50 000/mm3 and/or prothrombin time < 50 %; (ii) performance of surgery, endoscopic retrograde cholangiopancreatography (ERCP), a percutaneous biopsy attempt, or another invasive procedure within 7 days before EUS-FNA; (iii) lack of informed consent. Serum amylase levels were determined before and 8 and 24 h after the procedure. Hyperamylasemia was defined by amylase levels above 104 UI/L (and higher than baseline levels) 8 h after the procedure. Acute pancreatitis was defined by upper abdominal pain (with or without nausea and/or vomiting) accompanied by elevation of serum amylase or lipase to at least twice baseline levels.

Results: A total of 100 patients underwent EUS-FNA of a pancreatic lesion (58 men, 42 women; mean age 60 ± 13 years). Eleven patients (11 %) showed hyperamylasemia 8 h after the puncture (298 ± 293 UI/L, range 105 - 1044 UI/L), but only two of them developed acute mild pancreatitis after EUS-FNA. Hyperamylasemia was not related either to the type of lesion (cystic or solid) or to its location, the duration of the procedure, or the number of passes performed.

Conclusions: Pancreatitis after pancreatic EUS-FNA occurs in 2 % of patients, with some more cases of silent hyperamylasemia. This complication may have to be included in the information given to patients for their informed consent.

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À. Ginès, MD, PhD 

Endoscopy Unit
Institut de Malalties Digestives
Hospital Clinic

Villarroel 170
08036 Barcelona
Spain

Fax: +34-93-2279387

Email: magines@clinic.ub.es

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