Gadour Eyad, Miutescu Bogdan, Okasha Hussein H, Albeshir Mohammed, Alamri Turki, Ghoneem Elsayed, Burciu Călin, Popa Alexandru, Koppandi Oana, AlQahtani Mohammed S
Multiorgan Transplant Centre of Excellence, Liver Transplantation Unit, King Fahad Specialist Hospital, Dammam 32253, Saudi Arabia.
Department of Medicine, Zamzam University College, School of Medicine, Khartoum 11113, Sudan.
World J Gastrointest Endosc. 2025 Jul 16;17(7):108541. doi: 10.4253/wjge.v17.i7.108541.
Endoscopic ultrasound (EUS) has evolved from a diagnostic tool to a management technique for various gastroenterological conditions, including biliary strictures.
To summarize the current evidence on EUS's role in diagnosing and managing biliary strictures.
Two independent reviewers searched five electronic databases (PubMed, CENTRAL, Science Direct, Google Scholar, and EMBASE) for articles published up to January 2025. Included articles met specific criteria, and statistical software was used to analyze reported outcomes.
Of 935 articles, 19 met the inclusion criteria. Ten articles focused on diagnostic EUS, while nine focused on EUS-guided therapeutic interventions. EUS fine-needle aspiration demonstrated superior sensitivity [0.43-1.00; 95% confidence interval (CI): 0.24-1.00] compared to conventional techniques (0.36-0.96; 95%CI: 0.19-0.99) for diagnosing malignant biliary strictures. Both EUS-fine-needle aspiration and conventional methods exhibited high specificity, with most achieving 100% specificity. EUS-guided interventions showed significantly higher clinical success rates than control interventions (odds ratio = 2.89; 95%CI: 1.22-6.84; = 0.02). No significant difference was observed in technical success rates (odds ratio = 0.97; 95%CI: 0.30-3.16; = 0.96).
EUS is a promising tool for diagnosing and managing biliary strictures. Combining EUS-guided and conventional interventions improves diagnostic performance. Further research is needed to investigate the feasibility and use of EUS-guided interventions in this field.
内镜超声（EUS）已从一种诊断工具发展成为用于包括胆管狭窄在内的各种胃肠疾病的管理技术。
总结当前关于EUS在诊断和管理胆管狭窄中作用的证据。
两名独立评审员在五个电子数据库（PubMed、CENTRAL、Science Direct、谷歌学术和EMBASE）中检索截至2025年1月发表的文章。纳入的文章符合特定标准，并使用统计软件分析报告的结果。
在935篇文章中，19篇符合纳入标准。10篇文章聚焦于诊断性EUS，而9篇聚焦于EUS引导的治疗性干预。与传统技术（0.36 - 0.96；95%置信区间[CI]：0.19 - 0.99）相比，EUS细针穿刺在诊断恶性胆管狭窄方面显示出更高的敏感性[0.43 - 1.00；95%CI：0.24 - 1.00]。EUS细针穿刺和传统方法均表现出高特异性，大多数达到100%特异性。EUS引导的干预显示出比对照干预显著更高的临床成功率（优势比 = 2.89；95%CI：1.22 - 6.84；P = 0.02）。技术成功率未观察到显著差异（优势比 = 0.97；95%CI：0.30 - 3.16；P = 0.96）。
EUS是诊断和管理胆管狭窄的一种有前景的工具。将EUS引导的和传统的干预相结合可提高诊断性能。需要进一步研究来调查EUS引导的干预在该领域的可行性和应用。
