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Assessment of morbidity and mortality associated with endoscopic ultrasound‐guided fine‐needle aspiration for pancreatic cystic lesions: A systematic review and meta‐analysis
Author(s) -
Zhu Huiyun,
Jiang Fei,
Zhu Jianwei,
Du Yiqi,
Jin Zhendong,
Li Zhaoshen
Publication year - 2017
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.12851
Subject(s) - medicine , endoscopic ultrasound , fine needle aspiration , meta analysis , radiology , general surgery , pathology , biopsy
Background and Aim With increased availability of imaging technology, detection of pancreatic cystic lesions ( PCL ) is on the rise. Endoscopic ultrasound‐guided fine‐needle aspiration ( EUS ‐ FNA ) improves the diagnosis accuracy of PCL . Systematic evaluation of morbidity and mortality associated with EUS ‐ FNA for PCL has not been carried out. We conducted a systematic review and meta‐analysis of morbidity and mortality associated with EUS ‐ FNA . Methods A literature search for relevant English‐language articles was conducted on PubMed and EMBASE databases. Main outcome measures for this analysis were adverse effects of diagnostic EUS ‐ FNA , and the associated morbidity and mortality, in patients with PCL . Results Forty studies, with a combined subject population of 5124 patients with PCL , satisfied the inclusion criteria. Overall morbidity as a result of adverse events of EUS ‐ FNA was 2.66% (95% confidence interval [ CI ]: 1.84–3.62%), and the associated mortality was 0.19% (95% CI : 0.09–0.32%). Common post‐procedure adverse events included pancreatitis 0.92% (95% CI : 0.63–1.28%), hemorrhage 0.69% (95% CI : 0.42–1.02%), pain 0.49% (95% CI : 0.27–0.79%), infection 0.44% (95% CI : 0.27–0.66%), desaturation 0.23% (95% CI : 0.12–0.38%) and perforation 0.21% (95% CI : 0.11–0.36%). There was no peritoneal seeding in our study. Incidence of adverse events associated with prophylactic periprocedural antibiotic use was 2.77% (95% CI : 1.87–3.85%). Conclusions EUS ‐ FNA is a safe procedure for diagnosis of PCL and is associated with a relatively low incidence of adverse events. Most adverse events were mild, self‐limiting, and did not require medical intervention.