Statins decrease the risk of acute pancreatitis after endoscopic ultrasound fine-needle aspiration of pancreatic cysts.

Published on Feb 1, 2020in Hepatobiliary & Pancreatic Diseases International2.428
· DOI :10.1016/J.HBPD.2019.10.001
Antonio Facciorusso19
Estimated H-index: 19
(University of Foggia),
Vincenzo Rosario Buccino7
Estimated H-index: 7
(University of Foggia)
+ 3 AuthorsNicola Muscatiello22
Estimated H-index: 22
(University of Foggia)
Sources
Abstract
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 of endoscopic ultrasound fine-needle aspiration. We compared the acute pancreatitis incidence between the two groups, and we also compared other complications such as bleeding and infections. Results Median age was 64 years [interquartile range (IQR) 62-69] and median cyst size was 24 mm (IQR, 21-29). The most frequent histology was intraductal papillary mucinous neoplasm (45.3% and 42.3% in the two groups, respectively; P=0.98). All 13 patients experiencing post-endoscopic ultrasound acute pancreatitis were from the control group (4.7%), of which 3 were classified as severe pancreatitis. None of statin users developed post-procedural acute pancreatitis (odds ratio: 0.15; 95% confidence interval: 0.03-0.98; P=0.03). No difference was registered with regard to severe pancreatitis and other complications. Conclusions Statins exert a beneficial role in preventing acute pancreatitis in patients with pancreatic cysts undergoing endoscopic ultrasound-guided fine-needle aspiration. If confirmed in prospective trials, our findings may pave the way to an extensive use of statins as prophylactic agents in pancreatic interventional endoscopy.
References28
Newest
#1Antonio Facciorusso (University of Foggia)H-Index: 19
#2Vincenzo Rosario Buccino (University of Foggia)H-Index: 7
Last. Nicola Muscatiello (University of Foggia)H-Index: 22
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BACKGROUND: Cirrhotic patients are at increased risk of adverse events (AEs) after invasive procedures. However, the safety profile of endoscopic ultrasound (EUS) fine-needle aspiration in cirrhotic patients is still unknown. OBJECTIVES: To examine the AEs rate after EUS fine-needle aspiration in cirrhotic patients as compared to a control group of noncirrhotic patients. METHODS: Out of 735 patients with suspected abdominal lesions referred to our center between 2006 and 2018, after propensity-s...
4 CitationsSource
#1Antonio Facciorusso (University of Foggia)H-Index: 19
#2Vincenzo Rosario Buccino (University of Foggia)H-Index: 7
Last. Nicola Muscatiello (University of Foggia)H-Index: 22
view all 5 authors...
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.
11 CitationsSource
#1Taija Korpela (UH: University of Helsinki)H-Index: 4
Last. Enrique de-MadariaH-Index: 18
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Abstract Background Acute pancreatitis (AP) is the most common complication after endoscopic retrograde cholangiopancreatography (ERCP). Statins have been traditionally associated to an increased risk of AP, however, recent evidence suggests that statins may have a protective role against this disease. Aims Our primary aim is to investigate whether the use of statins has a protective effect against post-ERCP pancreatitis (PEP). Secondary outcomes are: to evaluate the effect of other drugs on the...
5 CitationsSource
#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...
11 CitationsSource
BACKGROUND/AIMS: The risk of developing pancreatitis induced by endoscopic ultrasound-guided fine needle aspiration (EUS FNA) is relatively small. However, patients undergoing sampling through the normal pancreatic parenchyma or the pancreatic duct may have a higher rate of pancreatitis. Here, we determine the factors associated with increased risk of acute pancreatitis in patients undergoing FNA through normal pancreatic parenchyma/pancreatic duct. METHODS: In this prospective study at a tertia...
2 CitationsSource
#1Mahmud Mahamid (Nazareth Hospital EMMS)H-Index: 16
#2Abdulla Watad (TAU: Tel Aviv University)H-Index: 25
Last. Eran GoldinH-Index: 36
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Background and aims: Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is one of the major complications of ERCP. Thus, several non-invasive as well as invasive strategies have been investigated as preventative therapies for PEP with various efficacy. Methods: We enrolled any patients who underwent ERCP both at the Shaare Zedek Medical Center in Jerusalem and EMMS Nazareth hospital. Association between use of statins and different variables were assessed with univaria...
9 CitationsSource
#1Antonio Facciorusso (University of Foggia)H-Index: 19
#2Matteo Martina (University of Foggia)H-Index: 1
Last. Nicola Muscatiello (University of Foggia)H-Index: 22
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...
11 CitationsSource
#1Guo-min LiH-Index: 3
#2Jie ZhaoH-Index: 3
Last. Jun LiuH-Index: 3
view all 7 authors...
Abstract Background Over the past several years, numerous studies investigated the anti-inflammatory effects of statin on patients with RA. However, the findings of the individual studies were often inconsistent or conflicting. Materials and methods The Pubmed, Web of Science, Embase, Cochrane Library and CNKI literature databases were searched in order to identify randomized controlled clinical trials where the association between the anti-inflammatory effect of statin and RA was investigated. ...
52 CitationsSource
14 CitationsSource
#2Margaret G. Keane (UCLH: University College Hospital)H-Index: 4
Last. Jose Lariño-NoiaH-Index: 18
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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...
9 CitationsSource
Cited By7
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#2Livia Archibugi (UniSR: Vita-Salute San Raffaele University)H-Index: 13
Last. Enrique de-MadariaH-Index: 18
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OBJECTIVES post-endoscopic retrograde cholangiopancreatography (ERCP) acute pancreatitis (PEP) is a frequent complication of this endoscopic procedure. Chronic statin intake has been linked to lower incidence and severity of acute pancreatitis (AP). Periprocedural rectal administration of non-steroidal anti-inflammatory drugs is protective against PEP, but the role of chronic acetylsalicylic-acid (ASA) treatment is unclear. We aimed to investigate whether statins and chronic ASA intake are assoc...
1 CitationsSource
#1Antonio Facciorusso (University of Foggia)H-Index: 19
Last. Luca BarresiH-Index: 22
view all 6 authors...
There is limited evidence on the role of chronic statin therapy in the prevention of acute pancreatitis after ERCP. The aim of this meta-analysis was to evaluate the efficacy of statins in the prop...
1 CitationsSource
#1Antonio FacciorussoH-Index: 19
#2Nicola MuscatielloH-Index: 22
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#1Antonio FacciorussoH-Index: 19
Last. Nicola MuscatielloH-Index: 22
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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 (2008–2019), after the propensity score matching of two groups were compared; 103 treated with CH-EUS-FNA (group 1) and 103...
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#1Antonio FacciorussoH-Index: 19
#2Antonio TurcoH-Index: 2
Last. Nicola MuscatielloH-Index: 22
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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: 19
#2Vincenzo Rosario Buccino (University of Foggia)H-Index: 7
Last. Rodolfo Sacco (University of Foggia)H-Index: 26
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Three-Hydroxy-3-methyl-glutaryl-coenzyme A (HMG co-A) reductase inhibitors (statins) represent an effective therapeutic tool used worldwide in the treatment of dyslipidemia, and a growing body of e...
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#1Yousaf Hadi (WVU: West Virginia University)H-Index: 4
#2Syeda Fatima Zehra Naqvi (WVU: West Virginia University)H-Index: 2
Last. John Nasr (WVU: West Virginia University)H-Index: 9
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BACKGROUND: One of the most feared complications of endoscopic retrograde cholangiopancreatography (ERCP), with an incidence of 3.5 to 15%, is post ERCP pancreatitis (PEP). Given the role of statins in the reduction of systemic and pancreatic intraluminal inflammation, we hypothesized that the use of statins may lower the risk of PEP. METHODS: A retrospective cohort study of all patients undergoing ERCP at West Virginia University during the years 2016 and 2017 was performed. Possible associatio...
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