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- W4316081477 abstract "Introduction: There is scarce evidence on the impact of biliary stents on endoscopic ultrasound (EUS) fine-needle biopsy (FNB) or fine-needle aspiration (FNA) of pancreatic head masses. Aim of this meta-analysis was to compare the diagnostic performance of EUS-guided tissue sampling in patients with or without biliary stents. Methods: We searched PubMed/Medline and Embase databases through March 2022 and identified 7 studies (2458 patients). Primary outcome was diagnostic accuracy. Secondary outcomes were sample adequacy, diagnostic sensitivity, specificity, and number of needle passes. We performed pairwise meta-analysis through a random effects model and expressed results as odds ratio (OR) or mean difference along with 95% confidence interval (CI). Results: Pooled accuracy was 85.4% (95% CI 78.8%-91.9%) and 88.1% (83.3%-92.9%) in patients with and without stent, respectively with no significant difference between the two approaches (OR 0.74, 95% CI 0.53-1.02; p=0.07). No difference in patients with plastic stent was observed (OR 0.89, 0.51-1.54; p=0.67) whereas a significant difference was observed in patients with metal stent (OR 0.54, 0.17-0.97; p=0.05). Diagnostic accuracy with EUS-FNB was significantly lower in patients with biliary stents (OR 0.64, 0.43-0.95; p=0.03) whereas no difference was observed with FNA. No difference in terms of sample adequacy was observed between the two groups (OR 1.06, 0.67-1.67; p=0.81). Diagnostic sensitivity was significantly lower in patients with biliary stent (OR 0.59, 0.44-0.80; p< 0.001) and the number of needle passes was not significantly different between the two groups (mean difference -0.09, -0.30 to 0.11; p=0.38). Conclusion: The presence of a metal stent negatively impacts on diagnostic yield of EUS tissue sampling for pancreatic head lesions, whereas no difference seems to be observed with plastic stents. Therefore, in jaundiced patients, EUS tissue sampling should precede ERCP, especially when metal stents are used.Figure 1.: Forest plot of diagnostic accuracy analysis" @default.
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- W4316081477 date "2022-10-01" @default.
- W4316081477 modified "2023-10-16" @default.
- W4316081477 title "S1122 Impact of Biliary Stents on Diagnostic Yield of Endoscopic Ultrasound-Guided Tissue Acquisition of Solid Pancreatic Head Lesions: A Systematic Review and Meta-Analysis" @default.
- W4316081477 doi "https://doi.org/10.14309/01.ajg.0000861128.84531.01" @default.
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