Gastroenterology Unit of Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru; Universidad Peruana de Ciencias Aplicadas (UPC), Peru; Gastroenterology Unit of Angloamericana Clinic, Lima, Peru.
Gastroenterology Unit of Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru.
Gastroenterol Hepatol. 2024 Apr;47(4):327-336. doi: 10.1016/j.gastrohep.2023.05.015. Epub 2023 Jun 5.
Pancreatobiliary tumours are challenging to diagnose exclusively by imaging methods. Although the optimum moment for carrying out the EUS is not well defined, it has been suggested that the presence of biliary stents may interfere with the proper staging of tumours and the acquisition of samples. We performed a meta-analysis to evaluate the impact of biliary stents on EUS-guided tissue acquisition yield.
We conducted a systematic review in different databases, such as PubMed, Cochrane, Medline, and OVID Database. A search was made of all studies published up to February 2022.
Eight studies were analyzed. A total of 3185 patients were included. The mean age was 66.9±2.7 years; 55.4% were male gender. Overall, 1761 patients (55.3%) underwent EUS guided tissue acquisition (EUS-TA) with stents in situ, whereas 1424 patients (44.7%) underwent EUS-TA without stents. The technical success was similar in both groups (EUS-TA with stents: 88% vs EUS-TA without stents: 88%, OR=0.92 [95% CI 0.55-1.56]). The type of stent, the needle size and the number of the passes were similar in both groups.
EUS-TA has similar diagnostic performance and technical success in patients with or without stents. The type of stent (SEMS or plastic) does not seem to influence the diagnostic performance of EUS-TA. Future prospectives and RCT studies are needed to strengthen these conclusions.
单独通过影像学方法诊断胰胆肿瘤具有挑战性。尽管进行 EUS 的最佳时机尚未明确，但有人认为胆管支架的存在可能会干扰肿瘤的正确分期和样本采集。我们进行了一项荟萃分析，以评估胆管支架对 EUS 引导下组织获取产量的影响。
我们在不同的数据库（如 PubMed、Cochrane、Medline 和 OVID 数据库）中进行了系统评价。搜索了截至 2022 年 2 月发表的所有研究。
分析了 8 项研究。共纳入 3185 例患者。平均年龄为 66.9±2.7 岁；55.4%为男性。总体而言，1761 例患者（55.3%）在原位放置支架的情况下进行了 EUS 引导下组织获取（EUS-TA），而 1424 例患者（44.7%）在没有支架的情况下进行了 EUS-TA。两组的技术成功率相似（EUS-TA 有支架：88% vs EUS-TA 无支架：88%，OR=0.92[95%CI 0.55-1.56]）。两组的支架类型、针的大小和进针次数相似。
有或没有支架的患者进行 EUS-TA 具有相似的诊断性能和技术成功率。支架类型（SEMS 或塑料）似乎不会影响 EUS-TA 的诊断性能。需要进一步的前瞻性和 RCT 研究来加强这些结论。
