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

Abstract 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 tran...

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Main Authors: Go Endo, Kazunaga Ishigaki, Tsuyoshi Hamada, Yousuke Nakai, Kota Ishida, Kohei Kurihara, Shuichi Tange, Shinya Takaoka, Yurie Tokito, Yukari Suzuki, Hiroki Oyama, Sachiko Kanai, Tatsunori Suzuki, Tatsuya Sato, Ryunosuke Hakuta, Tomotaka Saito, Naminatsu Takahara, Mitsuhiro Fujishiro
Format: Article
Language:English
Published: Wiley 2024-04-01
Series:DEN Open
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Online Access:https://doi.org/10.1002/deo2.250
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author Go Endo
Kazunaga Ishigaki
Tsuyoshi Hamada
Yousuke Nakai
Kota Ishida
Kohei Kurihara
Shuichi Tange
Shinya Takaoka
Yurie Tokito
Yukari Suzuki
Hiroki Oyama
Sachiko Kanai
Tatsunori Suzuki
Tatsuya Sato
Ryunosuke Hakuta
Tomotaka Saito
Naminatsu Takahara
Mitsuhiro Fujishiro
author_facet Go Endo
Kazunaga Ishigaki
Tsuyoshi Hamada
Yousuke Nakai
Kota Ishida
Kohei Kurihara
Shuichi Tange
Shinya Takaoka
Yurie Tokito
Yukari Suzuki
Hiroki Oyama
Sachiko Kanai
Tatsunori Suzuki
Tatsuya Sato
Ryunosuke Hakuta
Tomotaka Saito
Naminatsu Takahara
Mitsuhiro Fujishiro
author_sort Go Endo
collection DOAJ
description Abstract 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.
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spelling doaj-art-68a031a5d3ed4734b7fccd54c98d35d02025-08-20T03:59:36ZengWileyDEN Open2692-46092024-04-0141n/an/a10.1002/deo2.250The 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‐analysisGo Endo0Kazunaga Ishigaki1Tsuyoshi Hamada2Yousuke Nakai3Kota Ishida4Kohei Kurihara5Shuichi Tange6Shinya Takaoka7Yurie Tokito8Yukari Suzuki9Hiroki Oyama10Sachiko Kanai11Tatsunori Suzuki12Tatsuya Sato13Ryunosuke Hakuta14Tomotaka Saito15Naminatsu Takahara16Mitsuhiro Fujishiro17Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo JapanDepartment of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo JapanDepartment of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo JapanDepartment of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo JapanDepartment of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo JapanDepartment of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo JapanDepartment of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo JapanDepartment of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo JapanDepartment of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo JapanDepartment of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo JapanDepartment of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo JapanDepartment of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo JapanDepartment of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo JapanDepartment of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo JapanDepartment of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo JapanDepartment of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo JapanDepartment of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo JapanDepartment of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo JapanAbstract 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.https://doi.org/10.1002/deo2.250cholangiopancreatographyendoscopic retrogradeendoscopic ultrasound‐guided fine needle aspirationjaundiceobstructivepancreatic neoplasms
spellingShingle Go Endo
Kazunaga Ishigaki
Tsuyoshi Hamada
Yousuke Nakai
Kota Ishida
Kohei Kurihara
Shuichi Tange
Shinya Takaoka
Yurie Tokito
Yukari Suzuki
Hiroki Oyama
Sachiko Kanai
Tatsunori Suzuki
Tatsuya Sato
Ryunosuke Hakuta
Tomotaka Saito
Naminatsu Takahara
Mitsuhiro Fujishiro
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
DEN Open
cholangiopancreatography
endoscopic retrograde
endoscopic ultrasound‐guided fine needle aspiration
jaundice
obstructive
pancreatic neoplasms
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic cholangiopancreatography
endoscopic retrograde
endoscopic ultrasound‐guided fine needle aspiration
jaundice
obstructive
pancreatic neoplasms
url https://doi.org/10.1002/deo2.250
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