Complications of Endoscopic Ultrasound and Endoscopic Ultrasound-Guided Interventions - Results of a Survey among German Centers

Background: Endoscopic ultrasonography is a widely used technique in Germany and not restricted to highly specialised centres. Complementary to the traditional radial scanners, longitudinally scanning echo endoscopes have gained considerable acceptation. Multicentre data on the complications of endoscopic ultrasound and endoscopic ultrasound-guided interventions at German centres do not exist. Method: From 2004 to 2006 all German centres performing endoscopic ultrasonography were surveyed and asked to report on their complications. Results: From 1991 to 2006 100604 endosonographic procedures had been performed in 67 centres (85084 diagnostic endosonographies without any intervention, 13223 endoscopic ultrasound-guided finde-needle aspiration biopsies, 2297 endoscopic ultrasound-guided therapeutic interventions). 38 centres reported on 104 complications, of which 88 were considered to be severe (overall complication rate 0.1%). Complications of diagnostic endoscopic ultrasound occurred at a rate of 0.034%, almost all of them were duodenal and oesophageal perforations. There had been complications in 0.29% of all endoscopic ultrasound-guided fine-needle aspiration biopsies and subsequent to 1.61% of all endoscopic ultrasound-guided therapeutic interventions. The overall mortality of non-interventional and interventional endosonographic procedures was 0.01%. Conclusions: Under the specific circumstances in Germany, endoscopic ultrasound, both conventional and interventional, was confirmed to be a safe diagnostic and therapeutic technique. In future, the prospective assessment of complications should become an essential part of quality management of endoscopic ultrasound.