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
Weitere Informationen

Publikationsverlauf

eingereicht 6 September 2006

akzeptiert 12 June 2007

Publikationsdatum:
30. Juli 2007 (online)

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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.

References

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