Risk of Pancreatitis After Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Pancreatic Cystic Lesions: A Systematic Review and Meta-Analysis.

Autor:	Magahis PT; Weill Cornell Medical College, MD Program, New York, New York, USA.; Division of Gastroenterology and Hepatology, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, New York, USA., Chhoda A; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA., Berzin TM; Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA., Farrell JJ; Department of Digestive Diseases, Yale School of Medicine, New Haven, Connecticut, USA., Wright DN; Samuel J. Wood Library, Weill Cornell Medical College, New York, New York, USA ., Rizvi A; Weill Cornell Medical College, MD Program, New York, New York, USA.; Division of Gastroenterology and Hepatology, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, New York, USA., Hanscom M; Weill Cornell Medical College, MD Program, New York, New York, USA.; Division of Gastroenterology and Hepatology, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, New York, USA., Carr-Locke DL; Weill Cornell Medical College, MD Program, New York, New York, USA.; Division of Gastroenterology and Hepatology, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, New York, USA., Sampath K; Weill Cornell Medical College, MD Program, New York, New York, USA.; Division of Gastroenterology and Hepatology, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, New York, USA., Sharaiha RZ; Weill Cornell Medical College, MD Program, New York, New York, USA.; Division of Gastroenterology and Hepatology, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, New York, USA., Mahadev S; Weill Cornell Medical College, MD Program, New York, New York, USA.; Division of Gastroenterology and Hepatology, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, New York, USA.
Jazyk:	angličtina
Zdroj:	The American journal of gastroenterology [Am J Gastroenterol] 2024 Nov 01; Vol. 119 (11), pp. 2174-2186. Date of Electronic Publication: 2024 Jul 05.
DOI:	10.14309/ajg.0000000000002942
Abstrakt:	Introduction: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is frequently used to risk-stratify pancreatic cystic lesions (PCLs). Rising PCL incidence and developments in tissue acquisition and specimen analysis necessitate updated appraisal of EUS-FNA safety, particularly the risk of postprocedure pancreatitis, the most common EUS-FNA-related adverse event. Our systematic review aims to accurately quantify the risk of EUS-FNA-related pancreatitis to best inform decisions regarding EUS-FNA's optimal role in PCL workup. Methods: We performed systematic searches in 4 databases from inception to April 2024 for original English-language studies investigating EUS-FNA-related pancreatitis. We extracted data on demographics and EUS-FNA-related pancreatitis risk, severity, and risk factors. These were meta-analyzed through the DerSimonian Laird Method using a random-effects model. Meta-regression of pancreatitis risk was performed to delineate associations with clinical and procedural characteristics. Results: Sixty-four studies comprised 8,086 patients and reported 110 EUS-FNA-related pancreatitis events. Pooled risk of EUS-FNA-related pancreatitis was 1.4% (95% confidence intervals, -0.8% to 3.5%; I2 = 0.00), which was predominantly of mild severity (67%) and uniformly nonfatal. Pancreatitis risk lacked significant association with sample size, age, sex, cyst size, needle caliber, or passes, although we noted trends toward higher risk in studies published after 2015, those using higher gauge needles (19 G vs 22 G/25 G), and those performing EUS-guided through-the-needle biopsy. Discussion: We note with high certainty that pancreatitis after EUS-FNA of PCLs is infrequent and mild in severity with no mortality in the included cohort. EUS-guided through-the-needle biopsy may serve as a significant risk factor for EUS-FNA-related pancreatitis risk; however, further studies are needed to delineate other predisposing characteristics. (Copyright © 2024 by The American College of Gastroenterology.)
Databáze:	MEDLINE
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