Endoscopic ultrasound-guided fine needle aspiration in cystic pancreatic lesions: is it still controversial?

Abstract

We read with great interest the article by K. de Jong et al. entitled “Endoscopic ultrasound-guided fine-needle aspiration of pancreatic cystic lesions provides inadequate material for cytology and laboratory analysis: initial results from a prospective study” [1]. The authors performed endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) in 128 patients with pancreatic cystic lesions of varying sizes. The authors reported a very low technical success rate for FNA in their consecutive patients because adequate cellular material and sufficient fluid for biochemical analysis were obtained in only 44 out of 128 patients (34 %) and 68 out of 128 (53 %) respectively. They reported no significant difference between the sizes of the cysts in cases with or without a classifying diagnosis, or between cases from which sufficient fluid for biochemical analysis was or was not obtained. Nevertheless, they indicated that EUS-FNA was a safe technique that could be performed with a very low complication rate (2.4 %).