RISK OF PANCREATITIS FOLLOWING ENDOSCOPIC ULTRASONOGRAPHY: A SYSTEMATIC REVIEW AND META-ANALYSIS
DOI:
https://doi.org/10.62710/0rfn1z86Keywords:
aspirasi jarum halus, faktor risiko, meta-analisis, pankreatitis, ultrasonografi endoskopikAbstract
Endoscopic ultrasonography-guided tissue sampling is widely used to diagnose pancreatic lesions, but pancreatitis remains a clinically relevant adverse event, and evidence on its risk factors is inconsistent. This systematic review and meta-analysis aimed to summarize the incidence of pancreatitis after endoscopic ultrasonography and to evaluate patient- and procedure-related risk factors. PubMed, Scopus, and the Cochrane Library were searched for studies reporting pancreatitis after endoscopic ultrasonography and evaluating risk factors. Risk factors reported in at least two studies with extractable dichotomous data were pooled as risk ratios with 95% confidence intervals using the Mantel–Haenszel fixed-effect model. Five studies were included: two cohort studies, a multicenter pooled analysis, a retrospective case–control study, and a case report. The reported incidence of pancreatitis ranged from 0.29% to 9.2%, reflecting differences in study populations and procedural risk. Only two studies provided data suitable for pooling. Pancreatitis was not significantly associated with sex (risk ratio 1.13; 95% confidence interval 0.48–2.64), history of pancreatitis (1.50; 0.60–3.75), or sampling of the pancreatic head versus other locations (1.21; 0.50–2.94), and no between-study heterogeneity was observed. In individual studies, recent acute pancreatitis and side-branch intraductal papillary mucinous neoplasm were associated with a higher risk. Pancreatitis after endoscopic ultrasonography-guided pancreatic sampling is uncommon, and its reported incidence varies with patient selection and procedural characteristics. The pooled findings are limited by the small number of studies and participants. Recent pancreatitis and needle passage through the pancreatic duct or normal parenchyma may identify patients at higher risk and warrant prospective investigation.
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