Abstract
Tu1348 EFFICACY AND SAFETY OF EUS-THROUGH THE NEEDLE BIOSPY (EUS-TTNB) IN THE DIAGNOSIS OF PANCREATIC CYSTIC LESIONS: A META-ANALYSIS AND SYSTEMATIC REVIEW
Gastrointestinal endoscopy, Vol.89(6 Supplement), pp.AB584-AB584
06/2019
DOI: 10.1016/j.gie.2019.03.1005
Abstract
Background and Aims
EUS-through the needle biopsy (EUS-TTNB) is an emerging technique of EUS guided tissue sampling for pancreatic cystic lesions (PCLs). Recent studies have reported that EUS-TTNB of PCLs may have a better diagnostic yield compared with EUS-guided fine needle aspiration (FNA) without increasing adverse events. We performed a literature review of available published studies to evaluate the diagnostic yield, specimen adequacy, and adverse events associated with EUS-TTNB in diagnosis of PCLs.
Methods
We conducted a comprehensive search of multiple electronic databases and conference proceedings including PubMed, EMBASE, and Web of Science databases (from inception to November 22 2018) to identify studies (with ≥ 10 patients) reporting on technical success, clinical success, and adverse events of EUS-TTNB for PCLs. In case of multiple publications from the same cohort, data from the most recent and/ or most appropriate comprehensive report were included. The primary outcome was to estimate the pooled rates of technical success and clinical success. Technical success was defined as successful puncture of the pancreatic cyst and extraction of at least one biopsy. Clinical success was defined as acquisition of useful histological results. The secondary outcome was to estimate the pooled rate of adverse events. All analyses were done using random effects model.
Results
A total of 5 studies with 276 patients were included. One study lacked a concrete number of adverse events. The pooled rate of technical success was 96.0% (265/276, 95% CI,93.0-98.0%). The pooled rate of clinical success was 81.2% (265/276, 95% CI, 76.0-85.6%), with I2=48.3%, whereas the pooled rate of clinical success of FNA analysis was 43.6% (120/275, 95% CI, 37.7-49.7 %). The pooled rate of adverse events with EUS-TTNB in 228 patients of 4 studies was 11.0% (25/228) with nine pancreatitis (3.9%, 9/228). No severe or fatal complications were reported in all 5 studies. Among 108 PCLs with a CEA level < 192 ng/mL, EUS-TTNB found 50% (54/108) to be mucinous. EUS-TTNB was clinically successful in 47/56 PCLs (83.9%) which underwent surgery afterward. Histology of EUS-TTNB was concordant with that of surgical specimen in 45/56 PCLs (80.4%).
Conclusion
This meta-analysis of available published studies demonstrated EUS-TTNB has excellent efficacy and safety in the diagnosis of PCLs. Histopathology of TTNB was highly concordant with that of surgical specimen.
Details
- Title: Subtitle
- Tu1348 EFFICACY AND SAFETY OF EUS-THROUGH THE NEEDLE BIOSPY (EUS-TTNB) IN THE DIAGNOSIS OF PANCREATIC CYSTIC LESIONS: A META-ANALYSIS AND SYSTEMATIC REVIEW
- Creators
- Rintaro Hashimoto - University of California, IrvineJason B. Samarasena - University of California, IrvineKenneth J. Chang - University of California, IrvineJohn Lee - University of California, IrvineYutaka Tomizawa - University of Washington
- Resource Type
- Abstract
- Publication Details
- Gastrointestinal endoscopy, Vol.89(6 Supplement), pp.AB584-AB584
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.gie.2019.03.1005
- ISSN
- 0016-5107
- eISSN
- 1097-6779
- Language
- English
- Date published
- 06/2019
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984696768202771
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