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• W3033182008 abstract "Endoscopic ultrasound (EUS) guided through-the-needle forceps biopsy (TTNFB) is the newer and safer technique shown to have higher histological yield as compared to the gold standard EUS guided fine needle aspiration (EUS-FNA) in the diagnosis of pancreatic cystic lesions (PCLs). We did systematic review and meta-analysis to evaluate the efficacy of TTNFB versus EUS-FNA in the diagnosis of PCLs. Comprehensive search of multiple electronic databases including PubMed, EMBASE, Web of Science databases, Google Scholar and manual search of references (from inception through October 2019) to identify the studies reporting the use of TTNFB and EUS-FNA versus TTNFB for the diagnosis of PCLs. The primary outcome was to evaluate technical success and histological/cytological yield of the TTNFB procedure. The subgroup analysis was then done to compare EUS-FNA versus TTNFB studies for technical success and histological/cytological yield. Technical success was defined as successful procurement of the sample for the histological/cytological diagnosis. The secondary outcome was to study overall adverse events. The meta-analysis was performed using Der Simonian and Laird random effect model. 5 studies reporting on 168 patients with mean age of 63.2 years were included.The location of tumor was reported in 4 studies. The most common location of the lesion was head/neck (40%) followed by the body (31%), tail (21%) and uncinate (8%) process of the pancreas. Both pooled technical success and histological/cytological yield was calculated out of the number of procedures.The pooled technical success rate was 94% (95% CI= 77-100, I2=90%).The pooled histological diagnosis yield was 73% (95% CI=48-92, I2=90%). The pooled overall adverse event rates were 3% (95% CI= 0-12, I2 = 75%). In subgroup analysis, 6 studies reporting on 181 patients comparing EUS-FNA versus TTNFB were included. The mean age was 67.9 years. The most common location of the lesion was head/neck (40%) followed by the body (34%) and then tail (26%) of the pancreas.The pooled technical success rate was comparable in both the groups with p=0.46(Fig1).The pooled histological yield of TTNFB was higher (75.84%; 95% CI= 67.73-83.18, I2=24.09%) than cytological yield of EUS-FNA (45.48%; 95% CI= 21.73-70.27, I2=90.42%) with p=0.021 which was statistically significant(Fig2).The pooled overall adverse event rates (TTNFB- 2.31%;95%CI=0.00-7.24 versus EUS-FNA- 0%;95%CI=0.00-1.28) were comparable in both the groups with p=0.089. Substantial heterogeneity was noted in our meta-analysis. TTNFB has higher overall histological yield as compared to EUS-FNA in the diagnosis of PCLs(p=0.021) with comparable technical success and overall adverse event rates. The limitation of TTNFB is that you need FNA needle to use the forceps biopsy. Multi-center trials are needed to validate our findings.Fig 2Forest Plots comparing Pooled Histological/Cytological Diagnosis Yield: TTNFB versus EUS-FNA in the diagnosis of Pancreatic cystic lesionsView Large Image Figure ViewerDownload Hi-res image Download (PPT)" @default.
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• W3033182008 date "2020-06-01" @default.
• W3033182008 modified "2023-10-14" @default.
• W3033182008 title "Sa1438 EFFICACY OF ENDOSCOPIC ULTRASOUND GUIDED THROUGH-THE-NEEDLE FORCEPS BIOPSY VERSUS ENDOSCOPIC ULTRASOUND GUIDED FINE NEEDLE ASPIRATION IN THE DIAGNOSIS OF PANCREATIC CYSTIC LESIONS: IS THROUGH-THE-NEEDLE FORCEPS BIOPSY READY FOR PRIME TIME?" @default.
• W3033182008 doi "https://doi.org/10.1016/j.gie.2020.03.1234" @default.
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