Needle Tract Seeding after Endoscopic Ultrasound Tissue Acquisition of Pancreatic Lesions: A Systematic Review and Meta-Analysis
Antonio Facciorusso,
Stefano Francesco Crinò,
Paraskevas Gkolfakis,
Daryl Ramai,
Benedetto Mangiavillano,
Juliana Londoño Castillo,
Saurabh Chandan,
Babu P. Mohan,
Francesca D’Errico,
Francesco Decembrino,
Viktor Domislovic,
Andrea Anderloni
Affiliations
Antonio Facciorusso
Gastroenterology Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
Stefano Francesco Crinò
Gastroenterology and Digestive Endoscopy Unit, Department of Medicine, The Pancreas Institute, University Hospital of Verona, 37134 Verona, Italy
Paraskevas Gkolfakis
Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, CUB Erasme Hospital, Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium
Daryl Ramai
Gastroenterology and Hepatology, University of Utah Health, Salt Lake City, UT 84112, USA
Benedetto Mangiavillano
Gastrointestinal Endoscopy Unit, Humanitas—Mater Domini, 21053 Castellanza, Italy
Juliana Londoño Castillo
Gastroenterology Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
Saurabh Chandan
Gastroenterology Unit, CHI Health Creighton University Medical Center, Omaha, NE 68131, USA
Babu P. Mohan
Gastroenterology and Hepatology, University of Utah Health, Salt Lake City, UT 84112, USA
Francesca D’Errico
UOC Gastroenterologia ed Endoscopia Digestiva, Ente Ecclesiastico—Ospedale Generale Regionale “F.Miulli”, 70021 Acquaviva delle Fonti, Italy
Francesco Decembrino
UOC Gastroenterologia ed Endoscopia Digestiva, Ente Ecclesiastico—Ospedale Generale Regionale “F.Miulli”, 70021 Acquaviva delle Fonti, Italy
Viktor Domislovic
Department of Gastroenterology and Hepatology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
Andrea Anderloni
Gastroenterology and Digestive Endoscopy Unit, Fondazione I.R.C.C.S. Policlinico San Matteo, 27100 Pavia, Italy
There is limited evidence on the incidence of needle tract seeding (NTS) in patients undergoing endoscopic ultrasound (EUS) tissue acquisition (TA) of pancreatic lesions. This meta-analysis aimed to assess the incidence of NTS after EUS-TA. With a search of the literature up until April 2022, we identified 10 studies (13,238 patients) assessing NTS incidences in patients undergoing EUS-TA. The primary outcome was NTS incidence. The secondary outcome was a comparison in terms of peritoneal carcinomatosis incidence between patients who underwent EUS-TA and non-sampled patients. Results were expressed as pooled rates or odds ratio (OR) and 95% confidence intervals (CI). The pooled rate of NTS was 0.3% (95% CI 0.2–0.4%), with no evidence of heterogeneity (I2 = 0%). Subgroup analysis based on the type of sampled lesion confirmed this finding both in patients with pancreatic adenocarcinoma (0.4%, 0.2–0.6%) and in patients with cystic pancreatic lesions (0.3%, 0.1–0.5%). No difference in terms of metachronous peritoneal dissemination was observed between patients who underwent EUS-TA and non-sampled patients (OR 1.02, 0.72–1.46; p = 0.31), with evidence of low heterogeneity (I2 = 16%). Rates of NTS after EUS-TA are very low; therefore, EUS-TA could be safely performed in a pre-operative setting.
