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KMID : 1038120230560020169
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Clinical Endoscopy
2023 Volume.56 No. 2 p.169 ~ p.179
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Influence of biliary stents on the diagnostic outcome of endoscopic ultrasound?guided tissue acquisition from solid pancreatic lesions: a systematic review and meta-analysis
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Suprabhat Giri
Shivaraj Afzalpurkar
Sumaswi Angadi
Jijo Varghese
Sridhar Sundaram
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Abstract
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Background/Aims: This meta-analysis analyzed the effect of an indwelling biliary stent on endoscopic ultrasound (EUS)-guided tissue acquisition from pancreatic lesions.
Methods: A literature search was performed to identify studies published between 2000 and July 2022 comparing the diagnostic outcomes of EUS-tissue acquisition (TA) in patients with or without biliary stents. For non-strict criteria, samples reported as malignant or suspicious for malignancy were included, whereas for strict criteria, only samples reported as malignant were included in the analysis.
Results: Nine studies were included in this analysis. The odds of an accurate diagnosis were significantly lower in patients with indwelling stents using both non-strict (odds ratio [OR], 0.68; 95% confidence interval [CI], 0.52?0.90) and strict criteria (OR, 0.58; 95% CI, 0.46?0.74). The pooled sensitivity with and without stents were similar (87% vs. 91%) using non-strict criteria. However, patients with stents had a lower pooled sensitivity (79% vs. 88%) when using strict criteria. The sample inadequacy rate was comparable between groups (OR, 1.12; 95% CI, 0.76?1.65). The diagnostic accuracy and sample inadequacy were comparable between plastic and metal biliary stents.
Conclusions: The presence of a biliary stent may negatively affect the diagnostic outcome of EUS-TA for pancreatic lesions.
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KEYWORD
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Endoscopic ultrasound, Fine needle aspiration, Pancreatic cancer, Stent
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