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Diagnostic performance and safety of endoscopic ultrasound-guided tissue acquisition of gallbladder lesions: A systematic review with meta-analysis

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Abstract

Background

Endoscopic ultrasound (EUS)–guided tissue acquisition (TA) is widely used for various target samples, but its efficacy in gallbladder (GB) lesions is unknown. The aim of the present meta-analysis was to assess the pooled adequacy, accuracy and safety of EUS-TA of GB lesions.

Methods

A literature search from January 2000 to August 2022 was done for studies analyzing the outcome of EUS-guided TA in patients with GB lesions. Pooled event rates were expressed with summative statistics.

Results

The pooled rate of sample adequacy for all GB lesions and malignant GB lesions was 97.0% (95% CI: 94.5–99.4) and 96.6% (95% CI: 93.8–99.3), respectively. The pooled sensitivity and specificity for the diagnosis of malignant lesions were 90% (95% CI: 85–94; I2 = 0.0%) and 100% (95% CI: 86–100; I2 = 0.0%), respectively, with an area under the curve of 0.915. EUS-guided TA had a pooled diagnostic accuracy rate of 94.6% (95% CI: 90.5–96.6) for all GB lesions and 94.1% (95% CI: 91.0–97.2) for malignant GB lesions. There were six reported mild adverse events (acute cholecystitis = 1, self-limited bleeding = 2, self-limited episode of pain = 3) with a pooled incidence of 1.8% (95% CI: 0.0–3.8) and none of the patients had serious adverse events.

Conclusion

EUS-guided tissue acquisition from GB lesions is a safe technique with high sample adequacy and diagnostic accuracy. EUS-TA can be an alternative when traditional sampling techniques fail or are not feasible.

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Author information

Authors and Affiliations

  1. Department of Gastroenterology, Nizam’s Institute of Medical Sciences, Hyderabad, 500 082, India

    Suprabhat Giri & Sumaswi Angadi

  2. Department of Gastroenterology, Nanjappa Multispecialty Hospital, Davanagere, 577 005, India

    Shivaraj Afzalpurkar

  3. Department of Gastroenterology, Seth G S Medical College, K E M Hospital, Mumbai, 400 012, India

    Sidharth Harindranath

  4. Department of Gastroenterology, KM Cherian Institute of Medical Sciences, Kallissery, 689 124, India

    Jijo Varghese

  5. Department of Digestive Disease and Clinical Nutrition, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, 400 012, India

    Sridhar Sundaram

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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Suprabhat Giri, Sidharth Harindranath and Jijo Varghese. The first draft of the manuscript was written by Suprabhat Giri, Sumaswi Angadi and Shivaraj Afzalpurkar and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sridhar Sundaram.

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Not applicable for meta-analysis.

Conflict of interest

SG, SA, ShA, SH, JV and SS declare no competing interests.

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The authors are solely responsible for the data and the content of the paper. In no way, the Honorary Editor-in-Chief, Editorial Board Members, the Indian Society of Gastroenterology or the printer/publishers are responsible for the results/ findings and content of this article.

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Giri, S., Angadi, S., Afzalpurkar, S. et al. Diagnostic performance and safety of endoscopic ultrasound-guided tissue acquisition of gallbladder lesions: A systematic review with meta-analysis. Indian J Gastroenterol 42, 467–474 (2023). https://doi.org/10.1007/s12664-023-01374-4

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