OBJECTIVE: Widespread use of imaging procedures has promoted a higher identification of incidental pancreatic cysts (IPCs). However, little is known as to whether endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) could change the management strategy of patients having IPCs. This study has aimed to evaluate the management impact of EUS-FNA on IPCs. MATERIAL AND METHODS: Patients with pancreatic cysts (PCs) who were referred to EUS-FNA were recruited prospectively. The referring physicians were questioned about the management strategy for these patients before and after EUS-FNA. The impact of EUS-FNA on management was then evaluated. RESULTS: A total of 302 PC patients were recruited. Of these, 159 (52.6%) patients had asymptomatic IPCs. The average size was 2.3 cm (range: 0.2-7.1 cm), and 110 patients having smaller than 3 cm sized cysts. Lesions were located in the pancreatic head in 96 (61%) cases, and most patients (94%) had only a single cyst. The final diagnoses, obtained by EUS-FNA (91) and surgery (68), were 93 (58%) benign lesions, 36 (23%) cysts with malignant potential, 14 (9%) noninvasive malignancies, 10 (6%) malignant precursor lesions (PanIN), and 6 (4%) invasive malignancies. Management strategy changed significantly after EUS-FNA in 114 (71.7%) patients: 43% of the cases were referred to surgery, 44% of the patients were discharged from surveillance, and 13% of the cases were given further periodical imaging tests. CONCLUSION: EUS-FNA has a management impact in almost 72% of IPCs, with a major influence on the management strategy, either discharge rather than surgical resection or surgery rather than additional follow up.
OBJECTIVE: Widespread use of imaging procedures has promoted a higher identification of incidental pancreatic cysts (IPCs). However, little is known as to whether endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) could change the management strategy of patients having IPCs. This study has aimed to evaluate the management impact of EUS-FNA on IPCs. MATERIAL AND METHODS:Patients with pancreatic cysts (PCs) who were referred to EUS-FNA were recruited prospectively. The referring physicians were questioned about the management strategy for these patients before and after EUS-FNA. The impact of EUS-FNA on management was then evaluated. RESULTS: A total of 302 PC patients were recruited. Of these, 159 (52.6%) patients had asymptomatic IPCs. The average size was 2.3 cm (range: 0.2-7.1 cm), and 110 patients having smaller than 3 cm sized cysts. Lesions were located in the pancreatic head in 96 (61%) cases, and most patients (94%) had only a single cyst. The final diagnoses, obtained by EUS-FNA (91) and surgery (68), were 93 (58%) benign lesions, 36 (23%) cysts with malignant potential, 14 (9%) noninvasive malignancies, 10 (6%) malignant precursor lesions (PanIN), and 6 (4%) invasive malignancies. Management strategy changed significantly after EUS-FNA in 114 (71.7%) patients: 43% of the cases were referred to surgery, 44% of the patients were discharged from surveillance, and 13% of the cases were given further periodical imaging tests. CONCLUSION: EUS-FNA has a management impact in almost 72% of IPCs, with a major influence on the management strategy, either discharge rather than surgical resection or surgery rather than additional follow up.
Authors: Kamraan Madhani; Muhammad Yousaf; Ali Aamar; Kohtaro Ooka; Thiruvengadam Muniraj; Harry Aslanian; Ronald Salem; James J Farrell Journal: Endosc Int Open Date: 2019-03-15
Authors: Nan Ge; William R Brugge; Payal Saxena; Anand Sahai; Douglas G Adler; Marc Giovannini; Nonthalee Pausawasdi; Erwin Santo; Girish Mishra; William Tam; Mitsuhiro Kida; Jose G de la Mora-Levy; Malay Sharma; Muhammad Umar; Akio Katanuma; Linda Lee; Pramod Kumar Garg; Mohamad Ali Eloubeidi; Ho Khek Yu; Isaac Raijman; Brenda Lucia Arturo Arias; Manoop Bhutani; Silvia Carrara; Praveer Rai; Shuntaro Mukai; Laurent Palazzo; Christoph F Dietrich; Nam Q Nguyen; Mohamed El-Nady; Jan Werner Poley; Simone Guaraldi; Evangelos Kalaitzakis; Luis Carlos Sabbagh; Jose Lariño-Noia; Frank G Gress; Yuk-Tong Lee; Surinder S Rana; Pietro Fusaroli; Michael Hocke; Vinay Dhir; Sundeep Lakhtakia; Thawee Ratanachu-Ek; A S Chalapathi Rao; Peter Vilmann; Hussein Hassan Okasha; Atsushi Irisawa; Ryan Ponnudurai; Ang Tiing Leong; Everson Artifon; Julio Iglesias-Garcia; Adrian Saftoiu; Alberto Larghi; Carlos Robles-Medranda; Siyu Sun Journal: Endosc Ultrasound Date: 2019 Nov-Dec Impact factor: 5.628