Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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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

  • Suprabhat Giri (Department of Gastroenterology, Nizam's Institute of Medical Sciences) ;
  • Shivaraj Afzalpurkar (Institute of Gastrosciences and Liver, Apollo Multispecialty Hospital) ;
  • Sumaswi Angadi (Department of Gastroenterology, Nizam's Institute of Medical Sciences) ;
  • Jijo Varghese (Department of Gastroenterology, KM Cherian Institute of Medical Sciences) ;
  • Sridhar Sundaram (Department of Digestive Disease and Clinical Nutrition, Tata Memorial Hospital)
  • Received : 2022.10.12
  • Accepted : 2022.12.16
  • Published : 2023.03.30
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Abstract

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.

Keywords

References

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