Evolving role of endoscopic ultrasound in biliary stricture management: A meta-analysis and systematic review

Table 1 Characteristics of included diagnostic test accuracy studies

Ref.	Study design	Location of lesion	Sample size	Inclusion criteria	Diagnostic intervention	Gold standard	Findings	Center type
Novis et al, 2010[9]	Comparative study	Distal	46	Biliary obstruction	EUS-FNA and ERCP	Histology, surgery, and follow-up	Benign lesions (n = 7) and malignant lesions (n = 37)	SC
Fritscher-Ravens et al, 2004[10]	Prospective	Proximal	44	Patients with obstructive jaundice and a clinical suspicion of cancer	EUS-FNA	Autopsy, surgery, or follow-up	Benign (n = 12) and malignant (n = 31)	SC
Ohshima et al, 2011[11]	Prospective	Biliary	22	Patients with suspected malignant biliary strictures	EUS-FNA	Histology, surgery, and follow-up	Malignant (n = 16) and benign (n = 6)	SC
Weilert et al, 2014[12]	Prospective	Biliary	51	Patients with suspected pancreaticobiliary pathologies	EUS-FNA and ERCP	Surgery, definitive findings, and follow-up	Benign (n = 3) and malignant (n = 48)	SC
DeWitt et al, 2006[13]	Prospective	Proximal	24	Patients with suspected or confirmed proximal biliary strictures	EUS-FNA	Surgical pathology findings and follow-up	Malignant (n = 17) and benign (n = 7)	SC
Eloubeidi et al, 2004[17]	Prospective	Biliary	25	Patients with common bile duct strictures	EUS-FNA	Follow-up and surgical pathology	Malignant (n = 31) and benign (n = 7)	SC
Rösch et al, 2004[14]	Prospective	Biliary	50	Patients with indeterminate biliary strictures	EUS-FNA and ERCP	Follow-up and surgical pathology or other biopsy results	Malignant (n = 28) and benign (n = 22)	SC
Lee et al, 2019[15]	Prospective	Distal	181	Patients with suspected malignant biliary strictures	EUS-FNA, ERCP, and POC-FB	Surgical pathology findings and malignant diagnosis after biopsy or during follow-up	Malignant (n = 51) and benign (n = 8)	MC
Yeo et al, 2019[16]	Retrospective	Biliary	93	Patients with suspected biliary strictures	EUS-TS and ERCP-TS	Histopathology findings based on the surgical specimen, cytology findings of either EUS-TS or ERCP-TS, or during clinical follow-up	Malignant (n = 70) and benign (n = 16)	MC
Lee et al, 2017[18]	Prospective	Biliary	178	Patients with suspected malignant biliary strictures	ERCP with TPB and EUS-FNA	Histopathologic findings of the surgical specimens, diagnosis based on TPB or EUS-FNAB, or during the clinical imaging on follow-up	Malignant (n = 171) and benign (n = 7)	MC

EUS: Endoscopic ultrasound; FNA: Fine-needle aspiration; CI: Confidence interval; ERCP: Endoscopic retrograde cholangiopancreatography; SC: Surgical control; POC-FB: Peroral cholangioscopy with forceps biopsy; TS: Technical success; TPB: Transpapillary biopsy; FNAB: Fine needle aspiration biopsy; MC: Multi-center.