Pan Cheng-Ye, Wang Shi-Min, Cai Dong-Hao, Ma Jia-Yi, Li Shi-Yu, Guo Yibin, Jing Sun, Zhendong Jin, Wang Kaixuan
Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China.
Department of Gastroenterology, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China.
Dig Endosc. 2025 May;37(5):490-500. doi: 10.1111/den.14972. Epub 2025 Jan 9.
Previous research has conducted meta-analyses on the diagnostic accuracy of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB). However, studies on adverse events (AEs) have been limited and sporadic and have included a highly diverse group of patients (with upper and lower gastrointestinal tract issues) and needles of varying sizes (19-22-25G). The purpose of this systematic review and meta-analysis was to determine the incidence of AEs related to the utilization of 20-22G second-generation EUS-FNB needles subsequent to puncture of the upper gastrointestinal tract and adjacent organs.
We searched the PubMed, Embase, and SCIE databases from January 1, 2010, to December 31, 2023. The primary outcome was percentage of summary AEs. Subgroup analyses were based on needle type, needle size, and lesion site.
A total of 99 studies were included in the analysis, with 9303 patients. The overall AE rate for 20-22G second generation EUS-FNB needles in upper gastrointestinal EUS-FNB was 1.8% (166/9303), with bleeding being the most common AE at 44.0%. The percentages of pancreatitis, abdominal pain, and other AEs were 24.1%, 21.1%, and 10.8%, respectively. Patients undergoing hepatic EUS-FNB had the highest incidence of AEs at 14.0%, followed by submucosal lesions at 3.2% and pancreatic lesions at 2.6%.
EUS-FNB is a safe procedure with a relatively low risk of upper gastrointestinal AEs (1.8%) and no associated deaths. Postoperative bleeding and pancreatitis are the most common complications of EUS-FNB. Most AEs are mild and self-limiting in severity, and serious complications are very rare.
既往研究已对内镜超声引导下细针穿刺活检（EUS-FNB）的诊断准确性进行了荟萃分析。然而，关于不良事件（AE）的研究有限且零散，纳入的患者群体高度多样化（包括上、下消化道问题），且针的尺寸各异（19G - 22G - 25G）。本系统评价和荟萃分析的目的是确定在对上消化道及相邻器官进行穿刺后，使用20 - 22G第二代EUS-FNB针相关的不良事件发生率。
我们检索了2010年1月1日至2023年12月31日的PubMed、Embase和SCIE数据库。主要结局是汇总不良事件的百分比。亚组分析基于针的类型、针的尺寸和病变部位。
分析共纳入99项研究，9303例患者。在上消化道EUS-FNB中，20 - 22G第二代EUS-FNB针的总体不良事件发生率为1.8%（166/9303），出血是最常见的不良事件，占44.0%。胰腺炎、腹痛和其他不良事件的百分比分别为24.1%、21.1%和10.8%。接受肝脏EUS-FNB的患者不良事件发生率最高，为14.0%，其次是黏膜下病变患者，为3.2%，胰腺病变患者为2.6%。
EUS-FNB是一种安全的操作，上消化道不良事件风险相对较低（1.8%），且无相关死亡病例。术后出血和胰腺炎是EUS-FNB最常见的并发症。大多数不良事件程度较轻且为自限性，严重并发症非常罕见。
