The bleeding risk after endoscopic ultrasound-guided puncture of pancreatic masses

Marcel Razpotnik, Simona Bota, Mathilde Kutilek, Gerolf Essler, Jutta Weber-Eibel, Andreas Maieron, Markus Peck-Radosavljevic

Research output: Journal article (peer-reviewed)Journal article

5 Citations (Scopus)


BACKGROUND: Although EUS-fine-needle aspiration (FNA) is considered to be safe, there are limited studies on adverse events of fine-needle biopsy (FNB).

AIM: To compare the bleeding rate of EUS-FNA and EUS-FNB of solid and cystic pancreatic masses.

METHODS: Our retrospective study included EUS-FNA/FNB of solid and cystic pancreatic masses performed between 02/2017-03/2019 in Klinikum Klagenfurt and 11/2018-03/2019 in University Hospital St. Pölten, Austria. Minor bleeding was defined as an event with a duration of more than 1 min, no need for intervention, large coagulum on the puncture site, or decrease in hemoglobin ≥1.5 g/dL (but <2 g/dL). Major bleeding was defined as a reduction in hemoglobin level ≥2 g/dL, need for red cell transfusions, or interventional hemostasis.

RESULTS: About 202 patients were biopsied in that period (141 solid, 61cystic pancreatic masses). FNA needle was used in 54.6% of cases with solid pancreatic masses and 73.7% of cysts. Bleeding with hemodynamic instability was not observed in our cohort. In pancreatic cysts, minor bleeding was observed in 8.2% of cases and was associated with the use of FNB needles and lower platelet count. In solid tumors, one major bleeding (0.7%) from a duodenal vessel occurred and was immediately treated with hemoclip. In this group, minor bleeding was observed in 15.6% of cases. Overall, the bleeding rate correlates with the use of FNB needles.

CONCLUSION: Use of EUS-FNB needles increases the rate of minor bleeding for both solid and cystic pancreatic tumors, while major bleeding is a rare occurrence, irrespective of the needle type.

Original languageEnglish
Pages (from-to)205-210
Number of pages6
JournalScandinavian Journal of Gastroenterology
Issue number2
Publication statusPublished - Feb 2021


  • Endoscopic Ultrasound-Guided Fine Needle Aspiration/adverse effects
  • Humans
  • Needles
  • Pancreas
  • Pancreatic Cyst
  • Pancreatic Neoplasms
  • Retrospective Studies
  • fine needle aspiration
  • adverse events
  • fine needle biopsy
  • endoscopic ultrasound
  • Bleeding

ASJC Scopus subject areas

  • Gastroenterology


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