7167 Eus-guided fna complications: a prospective analysis.

Abstract

EUS-guided FNA complications: A prospective analysis. Background: EUS-guided FNA is now a widely accepted modality for diagnosing and sampling lesions in the gastrointestinal tract and surrounding structures. There is sparse data concerning complications associated with this relatively new endoscopic technique. Aim: This prospective study was undertaken to determine the frequency of complications associated with EUSguided FNA including bleeding, perforation, bacteremia, infectious complications and pancreatitis in the case of EUS-FNA of pancreatic lesions in our university hospital setting. Methods: All patients undergoing EUS-FNA between 1/98- 12/99 were enrolled in this study. Patients were excluded if they were on antibiotics or taking aspirin or NSAIDs. During the procedure, the patient s vitals were monitored and the site of EUSFNA was inspected carefully for signs of significant bleeding. Oral temperature was recorded before and at 30 and 60 minutes after the procedure. Blood cultures were collected in aseptic fashion 30 and 60 minutes after the procedure. Radiologic studies and blood tests (CBC, amylase, lipase) were obtained when indicated. All patients were contacted 1 week post-procedure. Results: One hundred patients underwent EUS-FNA of 107 lesions, mean number of passes was 3. There were 5 ampullary lesions, 14 esophageal, 3 gastric, 1 adrenal, 2 liver masses, 18 mediastinal masses, 61 pancreatic and 3 peripancreatic masses. There was no evidence of bleeding, perforation and pancreatitis. Blood cultures were negative except in 6 patients having one of two bottles positive for coagulase negative staphylococcus considered to be contaminant. Seventy patients had their procedure as an outpatient; none were admitted or seen post-procedure in the ER. All patients were doing well at call back one week post-procedure. Conclusion: EUS-guided FNA is an extremely safe procedure. Our data suggests that EUS-guided FNA does not induce Bacteremia and is not associated with infectious complications. Prophylactic antibiotics for endocarditis prior to EUS-guided FNA (other than those delineated by ASGE and AHA) is not indicated.