Comparison of safety and effectiveness between endoscopic ultrasound-guided and ultrasound-guided pancreatic biopsy in focal pancreatic disease: a multi-center, retrospective, propensity score analysis.

IF 10.1 2区医学 Q1 SURGERY

International journal of surgery Pub Date : 2025-10-09 DOI:10.1097/JS9.0000000000003591

Weilu Chai, Qiang Lu, Dong Xu, Kai Li, Weina Wan, Li Yu, Ran Li, Tian'an Jiang

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引用次数: 0

Abstract

Background: Endoscopic ultrasound (EUS) and ultrasound (US) are the two primary imaging modalities used to guide pancreatic needle biopsy. This study aimed to compare the diagnostic performance and complications associated with EUS- and US-guided pancreatic biopsies.

Methods: A total of 2517 consecutive patients who underwent 2583 cases of EUS- or US-guided pancreatic biopsy for focal pancreatic disease between January 2017 and December 2023 at seven university teaching hospitals were included. The endpoints evaluated were diagnostic inaccuracy, complications, and repeat biopsies for each method. The propensity score matching (PSM) method was used for the analysis.

Results: For the entire cohort, diagnostic inaccuracies were observed in 7.0% of cases in the EUS-guided biopsy group compared to 3.5% in the US-guided biopsy group, representing a statistically significant difference (p = 0.001). The rates of major (p = 1.000) and minor complications (p = 0.309) were similar between the two groups. The rate of repeat biopsies was significantly higher in the EUS-guided biopsy group than in the US-guided biopsy group (5.0% vs. 2.8%, p = 0.024). However, after balancing lesion characteristics using PSM, no significant differences were observed between the EUS- and US-guided biopsies in diagnostic inaccuracy (7.2% vs. 8.5%, p = 0.600), major complications (0.5% vs. 0%, p = 0.499), minor complications (1.7% vs. 0.2%, p = 0.069), or repeat biopsy rate (5.5% vs. 6.5%, p = 0.656). Subgroup analysis revealed that among patients with exophytic and backward growth pancreatic lesions, both diagnostic inaccuracy (7.1% vs. 33.3%, p = 0.001) and the repeat biopsy rate (10.7% vs. 27.8%, p = 0.029) were significantly lower in the EUS-guided biopsy group compared to the US-guided biopsy group.

Conclusions: This study confirmed that both EUS-guided and US-guided pancreatic biopsies are safe and effective for patients with focal pancreatic disease. After PSM, diagnostic inaccuracy, repeat biopsy and complication rates were similar, but EUS-guided biopsy was preferred for lesions with exophytic and backward growth morphology.

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超声内镜引导下和超声引导下胰腺活检在局灶性胰腺疾病中的安全性和有效性比较：一项多中心、回顾性、倾向评分分析

背景：超声内镜（EUS）和超声（US）是指导胰腺穿刺活检的两种主要成像方式。本研究旨在比较EUS和us引导下胰腺活检的诊断表现和并发症。方法：在2017年1月至2023年12月期间，共有2517名连续患者在7所大学教学医院接受了2583例EUS或us引导的局灶性胰腺疾病胰腺活检。评估的终点是诊断不准确、并发症和每种方法的重复活检。采用倾向得分匹配（PSM）方法进行分析。结果：在整个队列中，超声引导活检组诊断不正率为7.0%，超声引导活检组为3.5%，差异有统计学意义（p = 0.001）。两组主要并发症发生率（p = 1.000）和次要并发症发生率（p = 0.309）相似。超声引导下活检组的重复活检率明显高于超声引导下活检组（5.0% vs. 2.8%, p = 0.024）。然而，在使用PSM平衡病变特征后，EUS和us引导下的活检在诊断不准确性（7.2%对8.5%,p = 0.600）、主要并发症（0.5%对0%，p = 0.499）、轻微并发症（1.7%对0.2%,p = 0.069）或重复活检率（5.5%对6.5%,p = 0.656）方面没有显著差异。亚组分析显示，在外生性和向后生长的胰腺病变患者中，eus引导活检组的诊断不准确性（7.1% vs. 33.3%, p = 0.001）和重复活检率（10.7% vs. 27.8%, p = 0.029）均显著低于us引导活检组。结论：本研究证实eus引导和us引导胰腺活检对局灶性胰腺疾病患者是安全有效的。PSM后，诊断不准确、重复活检和并发症发生率相似，但对于外生和生长形态落后的病变，eus引导下的活检是首选。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International journal of surgery SURGERY-

CiteScore

17.70

自引率

3.30%

发文量

审稿时长

6-12 weeks

期刊介绍： The International Journal of Surgery (IJS) has a broad scope, encompassing all surgical specialties. Its primary objective is to facilitate the exchange of crucial ideas and lines of thought between and across these specialties.By doing so, the journal aims to counter the growing trend of increasing sub-specialization, which can result in "tunnel-vision" and the isolation of significant surgical advancements within specific specialties.