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Systematic Review and Meta-analysis
- 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, Shivaraj Afzalpurkar, Sumaswi Angadi, Jijo Varghese, Sridhar Sundaram
- Clin Endosc 2023;56(2):169-179. Published online February 15, 2023
- DOI: https://doi.org/10.5946/ce.2022.282
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Abstract
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Supplementary Material
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ePub - 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-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. -
Citations
Citations to this article as recorded by
- Comparison of standard vs auxiliary (contrast or elastography) endoscopic ultrasound-guided fine needle aspiration/biopsy in solid pancreatic lesions: A meta-analysis
Mitali Madhumita Rath, Prajna Anirvan, Jijo Varghese, Tara Prasad Tripathy, Ranjan K Patel, Manas Kumar Panigrahi, Suprabhat Giri
World Journal of Methodology.2025;[Epub] CrossRef - Role of Endoscopic Ultrasound in Diagnosis of Pancreatic Ductal Adenocarcinoma
Abhirup Chatterjee, Jimil Shah
Diagnostics.2023; 14(1): 78. CrossRef
- Comparison of standard vs auxiliary (contrast or elastography) endoscopic ultrasound-guided fine needle aspiration/biopsy in solid pancreatic lesions: A meta-analysis
- 5,109 View
- 128 Download
- 2 Crossref
Systematic Review and Meta-Analysis
- Mucosal incision-assisted biopsy versus endoscopic ultrasound-assisted tissue acquisition for subepithelial lesions: a systematic review and meta-analysis
- Suprabhat Giri, Shivaraj Afzalpurkar, Sumaswi Angadi, Sridhar Sundaram
- Clin Endosc 2022;55(5):615-625. Published online August 4, 2022
- DOI: https://doi.org/10.5946/ce.2022.133
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Abstract
PDFSupplementary MaterialPubReaderePub
- Background
/Aims: Mucosal incision-assisted biopsy (MIAB) for tissue acquisition (TA) from subepithelial lesions (SELs) is emerging as an alternative to endoscopic ultrasound (EUS)-guided TA. Only a limited number of studies compared the diagnostic utility of MIAB and EUS for upper gastrointestinal (GI) SELs; therefore, we conducted this systematic review and meta-analysis.
Methods
A comprehensive literature search from January 2020 to January 2022 was performed to compare the diagnostic accuracy and safety of MIAB and EUS-guided TA for upper GI SELs.
Results
Seven studies were included in this meta-analysis. The pooled technical success rate (risk ratio [RR], 0.96; 95% confidence interval [CI], 0.89–1.04) and procedural time (mean difference=–4.53 seconds; 95% CI, –22.38 to 13.31] were comparable between both the groups. The overall chance of obtaining a positive diagnostic yield was lower with EUS than with MIAB for all lesions (RR, 0.83; 95% CI, 0.71–0.98) but comparable when using a fine-needle biopsy needle (RR, 0.93; 95% CI, 0.83–1.04). The positive diagnostic yield of MIAB was higher for lesions <20 mm (RR, 0.75; 95% CI, 0.63–0.89). Six studies reported no adverse events.
Conclusions
MIAB can be considered an effective alternative to EUS-guided TA for upper GI SELs without an increased risk of adverse events. -
Citations
Citations to this article as recorded by- Endoscopic Diagnosis of Gastric Subepithelial Lesions < 20 mm: Current Strategies and Emerging Solutions
Yosuke Minoda, Shuzaburo Nagatomo, Haruei Ogino, Nao Fujimori, Eikichi Ihara
Digestive Endoscopy.2026;[Epub] CrossRef - Population-Based Efficacy of Tissue Acquisition for Subepithelial Lesions in the Upper Gastrointestinal Tract
Cynthia A. Verloop, Lieke Hol, Lars Perk, Femme Dircksmeier-Harinck, Pieter Honkoop, Tessa Romkens, Ingrid Schot, Jilling Bergmann, Rutger Quispel, Marco J. Bruno, Lydi M.J.W. van Driel
Journal of Clinical Gastroenterology.2026;[Epub] CrossRef - Diagnostic ability and adverse events of mucosal incision‐assisted biopsy for gastric subepithelial tumors: Systematic review and meta‐analysis
Eriko Koizumi, Osamu Goto, Akihisa Matsuda, Toshiaki Otsuka, Yumiko Ishikawa, Shun Nakagome, Masahiro Niikawa, Tsugumi Habu, Keiichiro Yoshikata, Kumiko Kirita, Hiroto Noda, Kazutoshi Higuchi, Takeshi Onda, Jun Omori, Naohiko Akimoto, Hiroshi Yoshida, Kat
Digestive Endoscopy.2025; 37(3): 236. CrossRef - Current Management Strategies for Patients with Gastrointestinal and Pulmonary Neuroendocrine Tumors
Yulia V. Mikheeva, Pavel O. Rumyantsev, Konstantin K. Puzakov, Konstantin Yu. Slashchuk, Daniil D. Omelchuk, Anastasia V. Potapenko, Sergey P. Medvedev
Russian Journal of Oncology.2025; 30(1): 41. CrossRef - Approach to upper gastrointestinal subepithelial lesions
Shrihari Anil Anikhindi, Rajesh Puri, Noriya Uedo, Kamlesh Taori, Anil Arora
Expert Review of Gastroenterology & Hepatology.2025; 19(7): 789. CrossRef - Diagnostic challenges of inflammatory submucosal tumor-like lesions: a multicenter propensity score-matching analysis
Mengting Yu, Jiao Li, Yongfeng Yan, Xiaoxiang Wang, Yanhui Mao, Dandan Jiang, Zhengkui Zhou, Yuanyuan Chen, Xiaobin Sun
BMC Gastroenterology.2025;[Epub] CrossRef - Technical outcomes and postprocedural courses of mucosal incision‐assisted biopsy for possible gastric gastrointestinal stromal tumors: A series of 48 cases (with video)
Eriko Koizumi, Osamu Goto, Shun Nakagome, Tsugumi Habu, Yumiko Ishikawa, Kumiko Kirita, Hiroto Noda, Kazutoshi Higuchi, Takeshi Onda, Teppei Akimoto, Jun Omori, Naohiko Akimoto, Katsuhiko Iwakiri
DEN Open.2024;[Epub] CrossRef - The Diagnostic Approach of Benign Esophageal Tumors: A Narrative Review
Alex R. Jones, Preksha Vankawala, Tarek Sawas
Current Treatment Options in Gastroenterology.2024; 22(2): 44. CrossRef - Unroofing of subepithelial lesions in the upper gastrointestinal tract using cold snare: an easy and efficient technique for diagnosis
Bernhard Morell, Frans Olivier The, Christoph Gubler, Fritz Ruprecht Murray
Clinical Endoscopy.2024; 57(2): 274. CrossRef - Diagnostic yield of endoscopic and EUS-guided biopsy techniques in subepithelial lesions of the upper GI tract: a systematic review
Cynthia A. Verloop, Jacqueline A.C. Goos, Marco J. Bruno, Rutger Quispel, Lydi M.J.W. van Driel, Lieke Hol
Gastrointestinal Endoscopy.2024; 99(6): 895. CrossRef - Small gastric subepithelial lesions: A sand in the eye
Tanyaporn Chantarojanasiri, Nikhil Sonthalia, Rashid N. Lui
Journal of Gastroenterology and Hepatology.2024; 39(7): 1207. CrossRef - EUS‐guided tissue acquisition from gastric subepithelial lesions—The optimal technique still remains undecided
Suprabhat Giri, Sridhar Sundaram
Australasian Journal of Ultrasound in Medicine.2024; 27(4): 263. CrossRef - Endoscopic Ultrasound and Gastric Sub-Epithelial Lesions: Ultrasonographic Features, Tissue Acquisition Strategies, and Therapeutic Management
Marzia Varanese, Marco Spadaccini, Antonio Facciorusso, Gianluca Franchellucci, Matteo Colombo, Marta Andreozzi, Daryl Ramai, Davide Massimi, Roberto De Sire, Ludovico Alfarone, Antonio Capogreco, Roberta Maselli, Cesare Hassan, Alessandro Fugazza, Alessa
Medicina.2024; 60(10): 1695. CrossRef - Efficacy of EUS-guided keyhole biopsies in diagnosing subepithelial lesions of the upper gastrointestinal tract
Sen Verhoeve, Cynthia Verloop, Marco Bruno, Valeska Terpstra, Lydi Van Driel, Lars Perk, Lieke Hol
Endoscopy International Open.2024; 12(10): E1183. CrossRef - Approach to Small Gastric Subepithelial Lesions
Moon Won Lee, Bong Eun Lee
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2023; 23(1): 28. CrossRef - Is the canalization to obtain deep biopsy of gastrointestinal subepithelial tumors miniprobe-guidded as an alternative to conventional known techniques?
Modesto Varas Lorenzo, Ramón Abad Belando
Revista Española de Enfermedades Digestivas.2023;[Epub] CrossRef - Role of Advanced Gastrointestinal Endoscopy in the Comprehensive Management of Neuroendocrine Neoplasms
Harishankar Gopakumar, Vinay Jahagirdar, Jagadish Koyi, Dushyant Singh Dahiya, Hemant Goyal, Neil R. Sharma, Abhilash Perisetti
Cancers.2023; 15(16): 4175. CrossRef
- Endoscopic Diagnosis of Gastric Subepithelial Lesions < 20 mm: Current Strategies and Emerging Solutions
- 6,092 View
- 165 Download
- 12 Web of Science
- 17 Crossref
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