Antibiotics Do Not Decrease the Rate of Infection After Endoscopic Ultrasound Fine-Needle Aspiration of Pancreatic Cysts.

Published on May 7, 2019in Digestive Diseases and Sciences3.199
路 DOI :10.1007/S10620-019-05655-X
Antonio Facciorusso21
Estimated H-index: 21
(University of Foggia),
Vincenzo Rosario Buccino8
Estimated H-index: 8
(University of Foggia)
+ 2 AuthorsNicola Muscatiello23
Estimated H-index: 23
(University of Foggia)
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Abstract
Background In spite of the weak evidence, antibiotic prophylaxis prior to endoscopic ultrasound-guided fine-needle aspiration of pancreatic cystic lesions is routinely used in the clinical practice.
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References23
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#1Christopher J. DiMaio (ISMMS: Icahn School of Medicine at Mount Sinai)H-Index: 17
: Pancreatic cystic lesions are a common clinical entity. The majority are neoplastic and have the potential for malignant transformation. To assist with patient management, a number of clinical guidelines have been developed over the past decade. However, controversies exist in regards to the various guidelines and treatment strategies they offer. This article will review the various clinical guidelines for management of pancreatic cysts, describe the limitations of these guidelines, and presen...
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#1Antonio Facciorusso (University of Foggia)H-Index: 21
#2Matteo Martina (University of Foggia)H-Index: 1
Last. Nicola Muscatiello (University of Foggia)H-Index: 23
view all 5 authors...
Background: Real-time elastography (RTE) may increase the diagnostic accuracy of fine-needle aspiration guided by endoscopic ultrasound. The aim of this study was to establish the diagnostic accuracy, sensitivity, and specificity of this combined methodological approach in a cohort of patients with solid pancreatic masses. Methods: We reviewed data from 54 patients with solid pancreatic lesions referred to our institution between January 2014 and June 2015. RTE, assessed in terms of strain ratio...
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#4Silvia Carrara (Humanitas University)H-Index: 15
For routine EUS-guided sampling of solid masses and lymph nodes (LNs) ESGE recommends 25G or 22G needles (high quality evidence, strong recommendation); fine needle aspiration (FNA) and fine needle biopsy (FNB) needles are equally recommended (high quality evidence, strong recommendation). When the primary aim of sampling is to obtain a core tissue specimen, ESGE suggests using 19G FNA or FNB needles or 22G FNB needles (low quality evidence, weak recommendation). ESGE recommends using 10-mL syri...
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#2Margaret G. Keane (UCLH: University College Hospital)H-Index: 15
Last. Jose Lari帽o-NoiaH-Index: 19
view all 6 authors...
Abstract Background/objectives To evaluate the agreement between the imaging modalities MRI-MRCP and EUS in cystic lesions of the pancreas which were thought to be a BD-IPMN. Methods Multicenter retrospective study included all patients between 2010 and 2015 with a suspected BD-IPMN who underwent an EUS and MRI-MRCP within 6 months or less of each other. Location, number, size, worrisome features and high-risk stigmata were evaluated. Interobserver agreement was evaluated by Kappa score. Results...
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#1Huiyun Zhu ('SMMU': Second Military Medical University)H-Index: 7
#2Fei Jiang ('SMMU': Second Military Medical University)H-Index: 3
Last. Zhao-Shen Li ('SMMU': Second Military Medical University)H-Index: 63
view all 6 authors...
Background and Aim With increased availability of imaging technology, detection of pancreatic cystic lesions (PCLs) is on the rise. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) improves the diagnosis accuracy of PCLs. Systematic evaluation of morbidity and mortality associated with EUS-FNA for PCLs has not been performed. We conducted a systematic review and meta-analysis of morbidity and mortality associated with EUS-FNA. Methods A literature search for relevant English-languag...
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#1Antonio Facciorusso (University of Foggia)H-Index: 21
#2Marianna Di Maso (University of Foggia)H-Index: 9
Last. Nicola Muscatiello (University of Foggia)H-Index: 23
view all 6 authors...
Background and aim Endoscopic ultrasonography guided-celiac plexus neurolysis relieves pain in pancreatic cancer patients but with often suboptimal and transient results. The study aims to compare the efficacy and safety of endoscopic ultrasound-guided tumor ethanol ablation combined with celiac plexus neurolysis with respect to celiac plexus neurolysis alone for pain management in pancreatic cancer patients. Methods Among 123 unresectable pancreatic cancer patients referred to our Institution b...
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#1Amir Klein (Westmead Hospital)H-Index: 15
#2Rose Qi (Westmead Hospital)H-Index: 1
Last. Vu Kwan (Westmead Hospital)H-Index: 12
view all 5 authors...
Background Endoscopic ultrasound (EUS) with fine-needle aspiration (FNA) is universally used for the investigation and diagnosis of pancreatic cystic lesions (PCL). Infectious complications following EUS-FNA of PCL are rare. Antibiotic prophylaxis to reduce the risk of infection is recommended; however, there is no consensus on the optimal regimen or route of administration. Potential advantages of a single-dose intravenous (IV) antibiotic over a prolonged oral regimen include simplicity, guaran...
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#1Priscilla A. van Riet (EUR: Erasmus University Rotterdam)H-Index: 5
#2Djuna L. Cahen (EUR: Erasmus University Rotterdam)H-Index: 29
Last. Marco J. Bruno (EUR: Erasmus University Rotterdam)H-Index: 70
view all 4 authors...
Background and study aims: Although Endoscopic Ultrasound (EUS)-guided tissue sampling is widely used, the optimal sampling strategy remains subject of debate. We evaluated practice patterns within the international endosonographic community. Patients and methods: An online questionnaire was sent to 400 endosonographers from the United States, Europe, and Asia. Results: A total of 186 (47鈥%) endosonographers participated: United States 54 (29鈥%), Europe 85 (46鈥%), and Asia 47 (25鈥%). European (7...
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#1Antonio Facciorusso (University of Foggia)H-Index: 21
#2Marianna Di Maso (University of Foggia)H-Index: 9
Last. Nicola Muscatiello (University of Foggia)H-Index: 23
view all 4 authors...
A 75-year-old man suffering from opioid-refractory due to an advanced pancreatic adenocarcinoma was treated with endoscopic ultrasound (EUS)-guided celiac plexus neurolysis (CPN) combined to EUS-guided tumor ablation. No major complications were recorded during the procedure. In the days following the procedure, mild diarrhea and fever were the only minor complications experienced by the patient. Complete tumor devascularization was assessed by means of computed tomography (CT) 48 h after the pr...
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Cited By12
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#1Ashraf A. Ashhab (Cedars-Sinai Medical Center)H-Index: 1
#2Stephen J. PandolH-Index: 77
Last. Simon K. LoH-Index: 30
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ABSTRACT Despite limited evidence, endoscopic societies recommend routine use of antibiotic prophylaxis for endoscopic ultrasound fine-needle aspiration of pancreatic cystic lesions. Recent studies suggest lack of benefit in this setting. Our objective is to conduct a systematic review and meta-analysis to assess the efficacy of antibiotics in prevention of infectious complications after ultrasound fine-needle aspiration of pancreatic cystic lesions. A bibliographic search of digital dissertatio...
Source
#1Antonio Facciorusso (University of Foggia)H-Index: 21
#2Vincenzo Rosario Buccino (University of Foggia)H-Index: 8
Last. Rodolfo Sacco (University of Foggia)H-Index: 27
view all 3 authors...
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#1Antonio FacciorussoH-Index: 21
#2Nicola MuscatielloH-Index: 23
Source
#1Antonio FacciorussoH-Index: 21
#2Christian CotsoglouH-Index: 10
Last. Nicola MuscatielloH-Index: 23
view all 6 authors...
Background: Whether endoscopic ultrasound (EUS) contrast-enhanced fine-needle aspiration (CH-EUS-FNA) determines superior results in comparison to standard EUS-FNA in tissue acquisition of pancreatic masses remains unclear. The aim of this study was to compare these two techniques on a series of patients with solid pancreatic lesions. Methods: 362 patients underwent EUS-FNA (2008鈥2019), after the propensity score matching of two groups were compared; 103 treated with CH-EUS-FNA (group 1) and 103...
Source
#1Antonio FacciorussoH-Index: 21
#2Antonio TurcoH-Index: 2
Last. Nicola MuscatielloH-Index: 23
view all 6 authors...
In spite of promising preliminary results, evidence supporting the use of non-anesthesiologist-administered propofol sedation (NAAP) in endoscopic ultrasound (EUS) procedures is still limited. The aim of this manuscript was to examine the safety and efficacy of NAAP as compared to anesthesiologist-administered propofol sedation in EUS procedures performed in a referral center. Out of 832 patients referred to our center between 2016 and 2019, after propensity score matching two groups were compar...
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#1Antonio Facciorusso (University of Foggia)H-Index: 21
#2Babu P. Mohan (UA: University of Arizona)H-Index: 14
Last. Luca BarresiH-Index: 24
view all 7 authors...
BACKGROUND There is limited evidence on the use of antibiotic prophylaxis prior to endoscopic ultrasound-guided fine-needle aspiration of pancreatic cysts. Aim of this meta-analysis was to evaluate the efficacy of antibiotic prophylaxis in this setting. RESEARCH DESIGN AND METHODS Bibliographic search was performed through January 2020. Primary outcome was infection rate. Additional endpoints were severe infection rate and overall rates of adverse events. RESULTS Six studies, of which 1 randomiz...
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#1Juan Colan-Hernandez (Autonomous University of Barcelona)H-Index: 4
#2Oriol Sendino (University of Barcelona)H-Index: 18
Last. Carlos Guarner-Argente (Autonomous University of Barcelona)H-Index: 14
view all 14 authors...
Abstract Background and aims Guidelines recommend routine antibiotic prophylaxis for patients undergoing endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of pancreatic cysts, but there is conflicting evidence for its necessity. We investigated whether the performing procedure without antimicrobial prophylaxis increases the incidence of infection. Methods We performed a multicenter, randomized, non-inferiority trial to compare prophylaxis with ciprofloxacin vs placebo in patients wit...
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Important advancements in endoscopic ultrasound-guided tissue sampling techniques and development of new needle designs have improved the diagnostic yield of pancreatic lesions. This innovation in endoscopic ultrasound has also opened the door for early diagnosis and precision therapy in the management of cancer patients. Endoscopic ultrasound fine needle biopsy is an invaluable tool and newer biopsy designs will probably play a pivotal role in the management of pancreatic lesions in the next fu...
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#1Antonio Facciorusso (University of Foggia)H-Index: 21
#2Vincenzo Rosario Buccino (University of Foggia)H-Index: 8
Last. Nicola Muscatiello (University of Foggia)H-Index: 23
view all 6 authors...
ABSTRACT Background Basic and clinical studies suggest that statins may prevent and even ameliorate acute pancreatitis. The present study was to evaluate whether statin decreases the risk of acute pancreatitis in patients undergoing endoscopic ultrasound-guided fine-needle aspiration of pancreatic cysts. Methods Out of 456 patients with pancreatic cysts referred to our center between 2006 and 2018, 365 were finally included in analyses: 86 were treated with statins and 279 were not at the time o...
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