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Rozzano, Italy

Tarantino I.,University of Palermo | Di Mitri R.,Civico A.R.N.A.S. Hospital | Fabbri C.,AUSL Bologna | Pagano N.,Humanitas Irccs | And 10 more authors.
Digestive and Liver Disease | Year: 2014

Background: Endoscopic ultrasound fine needle aspiration has a central role in the diagnostic algorithm of solid pancreatic masses. Data comparing the fine needle aspiration performed with different aspiration volume and without aspiration are lacking. We compared endoscopic ultrasound fine needle aspiration performed with the 22 gauge needle with different aspiration volumes (10, 20 and 0. ml), for adequacy, diagnostic accuracy and complications. Methods: Prospective clinical study at four referral centres. Endoscopic ultrasound fine needle aspiration was performed with a 22G needle with both volume aspiration (10 and 20 cc) and without syringe, in randomly assigned sequence. The cyto-pathologist was blinded as to which aspiration was used for each specimen. Results: 100 patients met the inclusion criteria, 88 completed the study. The masses had a mean size of 32.21. ±. 11.24. mm. Sample adequacy evaluated on site was 87.5% with 20. ml aspiration vs. 76.1% with 10. ml (p= 0.051), and 45.4% without aspiration (20. ml vs. 0. ml p<. 0.001; 10. ml vs. 0. ml p<. 0.001). The diagnostic accuracy was significantly better with 20. ml than with 10. ml and 0. ml (86.2% vs. 69.0% vs. 49.4% p<. 0.001). Conclusions: A significantly higher adequacy and accuracy were observed with the 20. ml aspiration puncture, therefore performing all passes with this volume aspiration may improve the diagnostic power of fine needle aspiration. © 2014 Editrice Gastroenterologica Italiana S.r.l. Source


Tarantino I.,University of Palermo | Fabbri C.,AUSL Bologna | Di Mitri R.,Civico A.R.N.A.S. Hospital | Pagano N.,Humanitas Irccs | And 6 more authors.
Digestive and Liver Disease | Year: 2014

Background: Endoscopic ultrasound-guided fine needle aspiration of pancreatic cystic lesions has been reported to have a higher complication rate than that of solid lesions, but the real complication rate is unknown. Aim of the study was to identify the complication rate of endoscopic ultrasound-guided fine needle aspiration and related risk factors. Methods: Prospective multicenter study at four referral centres. Data were collected from January 2010 to July 2012, searching for all adverse events related to guided fine needle aspiration. All complications occurring up to day 90 were recorded. Results: 298 patients (43.9% male, mean age 63.2. ±. 15.4 years) underwent endoscopic ultrasound-guided needle aspiration of pancreatic cystic lesions. Mean size was 34.1. ±. 9. mm. Adverse events occurred in 18 patients (6%): mild complications in 12/18 (66.6%), and moderate complications in 6/18 (33.3%). Seven were immediate, 6 early, and 5 late. All resolved with medical therapy. Conclusions: Endoscopic ultrasound-guided fine needle aspiration of pancreatic cystic lesions has been found to be associated with a higher complication rate than for solid lesions; however, the risk rate is acceptable considering the complication grade and the important diagnostic role of the technique in the management of pancreatic cystic lesions. © 2013 Editrice Gastroenterologica Italiana S.r.l. Source

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