Mo1405 False Positive Endoscopic Ultrasound Guided Fine Needle Aspiration Cytology for Solid Pancreatic Lesions

Abstract

choledocolithiasis (9), pancreatolithiasis (6), pancreatic duct stenosis (4) and other (3). ESCP was performed for malignant disease in 53 patients (69%). ERCP was not possible for difficult cannulation in 52 patients (67%) or an inaccessible ampulla in 25 patients (33%). Biliary and pancreatic drainage were attempted in 66 (86%) and 11 (14%) patients respectively, with a transgastric approach in 43 (56%) and transduodenal in 34 (44%). Ductography was achieved in 71/77 patients (92%), introduction of a wire into the biliary or pancreatic duct in 70/71 patients (98%), successful intraductal wire manipulation in 56/70 patients, rendezvous in 19/33, fistula dilation in 38/44 and transmural stent deployment in 31/38 patients. Technical success was achieved in 48 patients (62%) with clinical success in 45 of them. Intraductal wire manipulation was the most limiting stage and caused 16/29 failures. Complications occurred in 14 patients (18%) and as a direct consequence of them 4 patients passed away. Technical success was significantly better for endoscopists who performed more than 5 ESCP (75% vs 41%, p 0.004) and when the procedure was performed by 2 endoscopists (74% vs 52%, p 0.04). Other comparisons did not show a statistically significant influence on the final result. CONCLUSIONS: According to our data, outcomes of ESCP during its implantation stage in both community and referral hospitals reach a technical success of 62% with a complication rate of 18%. Intraductal manipulation of the wire seems to be the most difficult stage of the procedure. An experience of more than 5 ESCP and performance of the procedure by 2 endoscopists are factors which significantly improve the technical success of ESCP.