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
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
Affiliations
Go Endo
Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan
Kazunaga Ishigaki
Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan
Tsuyoshi Hamada
Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan
Yousuke Nakai
Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan
Kota Ishida
Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan
Kohei Kurihara
Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan
Shuichi Tange
Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan
Shinya Takaoka
Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan
Yurie Tokito
Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan
Yukari Suzuki
Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan
Hiroki Oyama
Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan
Sachiko Kanai
Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan
Tatsunori Suzuki
Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan
Tatsuya Sato
Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan
Ryunosuke Hakuta
Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan
Tomotaka Saito
Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan
Naminatsu Takahara
Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan
Mitsuhiro Fujishiro
Department of Gastroenterology Graduate School of Medicine the University of Tokyo Tokyo Japan
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.
