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Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jul 28, 2007; 13(28): 3861-3863
Published online Jul 28, 2007. doi: 10.3748/wjg.v13.i28.3861
Simultaneous endoscopic ultrasound fine needle aspiration and endoscopic retrograde cholangio-pancreatography: Evaluation of safety
Ilaria Tarantino, Luca Barresi, Marta Di Pisa, Mario Traina
Ilaria Tarantino, Luca Barresi, Marta Di Pisa, Mario Traina, Istituto Mediterraneo Trapianti e Terapie ad alta specializzazione, University of Pittsburgh Medical Center, Italy
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Ilaria Tarantino, Istituto Mediterraneo Trapianti e Terapie ad alta specializzazione, University of Pittsburgh Medical Center, Italy. itarantino@ismett.edu
Telephone: +39-91-2192111 Fax: +39-91-6665340
Received: February 26, 2007
Revised: March 18, 2007
Accepted: March 28, 2007
Published online: July 28, 2007
Abstract

AIM: To investigate the rate of complications of endoscopic retrograde cholangio-pancreatography (ERCP) performed immediately after endoscopic ultrasound fine needle aspiration (EUS-FNA) in a large series of patients.

METHODS: Patients with the following conditions were considered candidates for EUS-FNA and ERCP: diagnosis of locally advanced or metastatic pancreatic lesion not eligible for surgery, and patients with pancreatic lesion of unknown nature causing jaundice. Data were prospectively collected on the following parameters: indication for FNA, EUS findings, pathological diagnosis, procedure duration of EUS-FNA and combined EUS-FNA and ERCP, and immediate and late complications.

RESULTS: From January 2004 to October 2006, 72 patients were deemed eligible for combined EUS and ERCP. In 25/72 EUS-FNA was performed to obtain a pathology diagnosis of lesions causing biliary obstruction, and ERCP sequentially performed to drain the biliary system. No immediate complications occurred except for two mild bleeding episodes post sphincterotomy. No late complications were recorded except for one patient who experienced fever, promptly recovered with antibiotic therapy.

CONCLUSION: Simultaneous approach appears to be feasible and safe. When possible, this can be considered the reference standard to avoid double sedation and reduce duration of the procedure and hospital stay.

Keywords: Pancreatic mass; Endoscopic ultrasound fine needle aspiration; Biliary stent; Jaundice; Endoscopic therapy