目的:胰胆管肿瘤的诊断仅通过影像学方法具有挑战性。虽然执行EUS的最佳时刻没有很好的定义,有人认为,胆道支架的存在可能会干扰肿瘤的正确分期和样本的获取。我们进行了一项荟萃分析,以评估胆道支架对EUS引导的组织获取率的影响。
方法:我们在不同的数据库中进行了系统综述,比如PubMed,科克伦,Medline,OVID数据库。搜索了截至2022年2月发表的所有研究。
结果: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。总的来说,1761例患者(55.3%)接受EUS引导组织采集(EUS-TA)原位支架,而1424例患者(44.7%)在没有支架的情况下接受了EUS-TA。两组的技术成功率相似(EUS-TA有支架:88%vsEUS-TA无支架:88%,OR=0.92[95%CI0.55-1.56])。支架的类型,两组的针头大小和通过次数相似.
结论:EUS-TA在有或没有支架的患者中具有相似的诊断性能和技术成功。支架的类型(SEMS或塑料)似乎不影响EUS-TA的诊断性能。未来的前景和RCT研究需要加强这些结论。
OBJECTIVE: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.