The impact of biliary stents on the diagnostic yield of endoscopic ultrasound-guided fine needle aspiration for solid pancreatic lesions: A single-center retrospective study and meta-analysis.

Autor:	Endo G; Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan., Ishigaki K; Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan.; Department of Chemotherapy the University of Tokyo Hospital Tokyo Japan., Hamada T; Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan., Nakai Y; Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan.; Department of Endoscopy and Endoscopic Surgery the University of Tokyo Hospital Tokyo Japan., Ishida K; Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan., Kurihara K; Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan., Tange S; Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan., Takaoka S; Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan., Tokito Y; Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan., Suzuki Y; Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan., Oyama H; Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan., Kanai S; Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan.; Department of Endoscopy and Endoscopic Surgery the University of Tokyo Hospital Tokyo Japan., Suzuki T; Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan., Sato T; Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan., Hakuta R; Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan., Saito T; Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan., Takahara N; Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan., Fujishiro M; Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan.
Jazyk:	angličtina
Zdroj:	DEN open [DEN Open] 2023 Jul 10; Vol. 4 (1), pp. e250. Date of Electronic Publication: 2023 Jul 10 (Print Publication: 2024).
DOI:	10.1002/deo2.250
Abstrakt:	Background: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is widely used for the pathological diagnosis of solid pancreatic lesions but in cases with obstructive jaundice, transpapillary sampling can be performed during endoscopic retrograde cholangiopancreatography with transpapillary biliary stent placement. Thus, it is still controversial whether EUS-FNA should be performed prior to endoscopic retrograde cholangiopancreatography with biliary stent placement or only after negative transpapillary sampling. Methods: The accuracy, sensitivity, and specificity of EUS-FNA for solid pancreatic lesions with or without indwelling biliary stents were retrospectively studied in patients undergoing EUS-FNA between January 2017 and December 2021. We also conducted a meta-analysis including our data to compare the accuracy and sensitivity of EUS-FNA with or without biliary stents. Results: A total of 509 patients (40 with biliary stents and 469 without biliary stents) were included. The accuracy (77.5% vs. 94.5%, p < 0.001) and sensitivity (71.0% vs. 91.7%, p < 0.001) were lower in EUS-FNA with biliary stents. A meta-analysis confirmed that accuracy (odds ratio [OR] of 0.43, 95% confidence interval [CI] 0.29-0.62, p < 0.001) and sensitivity (OR of 0.46, 95% CI 0.33-0.64, p < 0.001) were lower in EUS-FNA with biliary stents. There were no statistically significant differences between plastic stents and self-expandable metallic stents for accuracy or sensitivity. Conclusions: The presence of biliary stents had a negative impact on the diagnostic performance of EUS-FNA, and EUS-FNA prior to endoscopic retrograde cholangiopancreatography with biliary stent placement should be considered in cases with obstructive jaundice. Competing Interests: Author Mitsuhiro Fujishiro has received honoraria from Fujifilm Corporation and Olympus Corporation and research grants from Fujifilm Corporation and Olympus Corporation. Author Yousuke Nakai is an editorial board member of Digestive Endoscopy and has received honoraria from Boston Scientific Japan, Gadelius medical corporation, Olympus Corporation, and research grants from Fujifilm Corporation and HOYA Corporation. (© 2023 The Authors. DEN Open published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu Plný text