Endoscopic ultrasound-guided fine-needle aspiration biopsy in the evaluation of bile duct strictures and gallbladder masses: a systematic review and meta-analysis

Abstract

Study objectives: Recently, there are very few research on endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of bile duct and gallbladder masses. The objective of this study was to assess the overall diagnostic accuracy of EUS-FNA in the evaluation of patients with bile duct strictures and gallbladder masses with a meta-analysis.

Methods: The MEDLINE, EMBASE, Cancerlit and Cochrane Library, and other database, from January 1995 to July 2010, were searched for studies evaluating EUS-FNA accuracy. Meta-analysis methods were used to obtain pooled estimates of sensitivity, specificity, diagnostic odds ratio, summary receiver operating characteristic curves, and the Q* index.

Results: A total of nine studies with 284 patients, who fulfilled all the inclusion criteria, were considered for the analysis. EUS-FNA had a pooled sensitivity of 0.84 (95% confidence interval: 0.78-0.88) and a pooled specificity of 1.00 (95% confidence interval: 0.94-1.00). Overall area under the curve was 0.9254, The Q* index was 0.8598 and the calculated diagnostic odds ratio was 75.1. No complications occurred.

Conclusion: EUS-FNA was an accurate and safe tool in the evaluation bile duct and gallbladder masses. High-quality prospective studies regarding EUS-FNA in the evaluation of patients with bile duct and gallbladder masses are still needed to be conducted.