Endoscopy 2020; 52(S 01): S56
DOI: 10.1055/s-0040-1704175
ESGE Days 2020 oral presentations
Thursday, April 23, 2020 16:30 – 18:00 Pancreatic cystic lesions Liffey Hall 1
© Georg Thieme Verlag KG Stuttgart · New York

DIAGNOSTIC PERFORMANCE OF ENDOSCOPIC ULTRASOUND THROUGH-THE-NEEDLE MICROFORCEPS BIOPSY (EUS-TTNB) OF PANCREATIC CYSTIC LESIONS: A SYSTEMATIC REVIEW WITH META-ANALYSIS

M Tacelli
1   San Raffaele Scientific Institute IRCCS, Pancreato-Biliary Endoscopy and EUS Division, Pancreas Translational and Clinical Research Center, Milan, Italy
2   University of Palermo, Section of Gastroenterology and Hepatology, Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), Palermo, Italy
,
C Celsa
2   University of Palermo, Section of Gastroenterology and Hepatology, Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), Palermo, Italy
,
B Magro
2   University of Palermo, Section of Gastroenterology and Hepatology, Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), Palermo, Italy
,
M Barchiesi
3   ASST FBF-Sacco, Department of Internal Medicine, Milan, Italy
,
L Barresi
4   IRCCS-ISMETT (Mediterranean Institute for Transplantation and Highly Specialized Therapies), Endoscopy Service, Department of Diagnostic and Therapeutic Services, Palermo, Italy
,
G Capurso
1   San Raffaele Scientific Institute IRCCS, Pancreato-Biliary Endoscopy and EUS Division, Pancreas Translational and Clinical Research Center, Milan, Italy
,
PG Arcidiacono
1   San Raffaele Scientific Institute IRCCS, Pancreato-Biliary Endoscopy and EUS Division, Pancreas Translational and Clinical Research Center, Milan, Italy
,
C Cammà
2   University of Palermo, Section of Gastroenterology and Hepatology, Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza (PROMISE), Palermo, Italy
,
SF Crinò
5   G.B. Rossi University Hospital, Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, Verona, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims Endoscopic ultrasound through-the-needle biopsy (EUS-TTNB) is a useful tool for differential diagnosis among pancreatic cystic lesions (PCLs). Cystic fluid cytology (CFC) is recommended by guidelines, but its diagnostic accuracy is about 50%. The aim of this meta-analysis is to assess the clinical impact of EUS-TTNB in terms of diagnostic capacity and accuracy.

Methods Observational studies on EUS-TTNB were searched in MEDLINE and EMBASE, until May 2019. Data on feasibility, histological accuracy (HA), diagnostic yield (DY) and adverse events (AEs) were extracted and pooled. Diagnostic accuracy of EUS-TTNB for identification of mucinous PCLs was calculated using individual diagnostic data of patients underwent CFC and surgery.

Results Nine studies including 454 patients underwent EUS-TTNB met the inclusion criteria for the meta-analysis. Feasibility and HA of EUS-TTNB were respectively 98.5% (95% Confidence Interval [CI] 97.3% - 99.6%) and 86.7% (95%CI 80.1-93.4). DY was 69.5% (95%CI 59.2-79.7) for EUS-TTNB and 28.7% (95%CI 15.7-41.6) for CFC. Heterogeneity persisted significantly high in most of subgroup analyses. In the multivariate meta-regression cyst size was independently associated with higher DY. Sensitivity and specificity for mucinous PCLs were 88.6 and 94.7% for EUS-TTNB, and 40 and 100% for CFC. AEs rate was 8.6% (95%CI 4.0-13.1).

Conclusions This meta-analysis shows that EUS-TTNB is a feasible technique that allows to obtain a high rate of adequate specimens for histology; in about two thirds of patients a specific histotype diagnosis could be assessed. The number of adverse events is slightly higher respect to standard EUS-FNA, but complications are very rarely severe.