Kaiser Permanente GI doing EUS procedure

I opted for an EUS w/FNA (Fine-Needle-Aspiration) because the cystic fluid obtained from the resulting biopsy was used to identify genetic mutations that are linked to cancer. For several years, I was on a 6 month alternating rotation of MRCP and EUS-FNA. Eventually, my medical team had enough info from the procedures to make good informed recommendations. As for special skills, yes - definitely. Even my normal GI folks referred me to GI specialists who mainly do the EUS-FNA procedures and have relationships with good research labs for analysis. As you mention, there can be complications but I experienced none.

A EUS can be done with or without a FNA. An EUS without a FNA is just an upper endoscopy ultrasound that poses no risk of pancreatitis. A EUS with FNA can trigger pancreatitis as it's taking a sample of your cyst. From my understanding is that not everyone experiences pancreatitis with FNA but it is a risk for a FNA procedure.

@sloped483 thanks for your reply . Do you know if an EUS will be able to classify the cyst better than the MRCP without contrast?

An EUS is better than an MRCP without contrast. I think to correctly classify a pancreatic cyst a biopsy (FNA) would be performed. I have 3 pancreatic cysts diagnosed from several MRCP's with contrast and for the most part it's been suggested that they are IPMN's (which are cysts in the side branches from the main pancreatic duct) but I do have my first EUS coming up in a week so I'm hoping it would glean more about them.

@lpaelevated4

@sloped483 with or without FNE? I wish you the best for your EUS.

@lpaelevated4,
Thanks.
I don't think my EUS will be with a FNA as my cysts are around 1 cm from my last MRCP in June and not big enough to get ample juice from them for a biopsy, if they haven't grown.

@sloped483 I believe the risk of pancreatitis from an FNA is about 1%. I think it is a very small risk compared to the benefits it provides.

@sloped483 please report back after your EUS. I see GI this Friday for consultation. Also, do you have to cleanse yourself like a colonoscopy or just fast?

@lpaelevated4, for an EUS this is no colon prep like for a colonoscopy, just fast. For me, I'm having a EUS (don't think I'm having a FNA) and a sigmoidoscopy (same as a colonoscopy but with a shorter scope as I've had most of my large intestine removed many years ago) so I would need to do a colon prep.
I've had upper endoscopies before but this is my first EUS and will let you know how it goes, although I feel both procedures will be uneventful.
Good luck with your consultation this Friday.