Limitations and Complications

Abstract

As EUS-FNA is an interventional procedure and similar to other interventional procedures, there is a potential risk of complications from either the needle puncture itself or endoscopic manipulation. However, if risky procedures are avoided and basic principles are adhered to, EUS-FNA can be regarded as a safe procedure. In our multicenter study (Wiersema 1997*), complications were reported in up to 2% of the cases. Most of these were of a minor nature. Minor bleeding is always seen at the puncture site, but this is limited to a few ml in most cases. Major bleeding requiring surgery has been described in only a few cases. Perforation, mainly due to trying to advance the endoscope through a stenotic tumor may be seen. However, this cannot be regarded as a direct consequence of the biopsy procedure itself. Naturally, one should avoid maneuvering the endoscope with the biopsy needle already introduced, since the exposed part of the metal sheath may injure the gastrointestinal wall.