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Predictors of adverse events after endoscopic ultrasound-guided through-the-needle biopsy of pancreatic cysts : a recursive partitioning analysis
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(2022) Predictors of adverse events after endoscopic ultrasound-guided through-the-needle biopsy of pancreatic cysts : a recursive partitioning analysis. Endoscopy, 54 (12). pp. 1158-1168. doi:10.1055/a-1831-5385 ISSN 1438-8812.
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Official URL: http://dx.doi.org/10.1055/a-1831-5385
Abstract
Background and study aims: Endoscopic ultrasound-guided through-the-needle biopsy (TTNB) of pancreatic cystic lesions (PCLs) is associated with a non-negligible risk for adverse events (AEs). We aimed to identify the hierarchic interaction among independent predictors for TTNB-related AEs and to generate a prognostic model using recursive partitioning analysis (RPA).
Patients and methods: Multicenter retrospective analysis of 506 patients with PCLs who underwent TTNB. RPA of predictors for AEs was performed and the model was validated by means of bootstrap resampling.
Results: Mean cysts size was 36.7 mm. Most common diagnoses were intraductal papillary mucinous neoplasm (IPMN, 45 %), serous cystadenoma (18.8 %), and mucinous cystadenoma (12.8 %). Fifty-eight (11.5 %) AEs were observed. At multivariate analysis, age (odds ratio [OR] 1.32, 1.09–2.14; p = 0.05), number of TTNB passes (OR from 2.17, 1.32–4.34 to OR 3.16, 2.03–6.34 with the increase of the number of passes), complete aspiration of the cyst (OR 0.56, 0.31–0.95; p = 0.02), and diagnosis of IPMN (OR 4.16, 2.27–7.69; p < 0.001) were found to be independent predictors of AEs, as confirmed by logistic regression and random forest analyses. RPA identified three risk classes: high-risk (IPMN sampled with multiple microforceps passes, 28 % AEs rate), low-risk (1.4 % AE rate, including patients < 64 years with other-than-IPMN diagnosis sampled with ≤ 2 microforceps passes and with complete aspiration of the cyst) and middle-risk class (6.1 % AEs rate, including the remaining patients).
Conclusion: TTNB should be selectively used in the evaluation of patients with IPMN. The present model could be applied during patient selection as to optimize the benefit/risk of TTNB.
Item Type: | Journal Article | ||||||
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Divisions: | Faculty of Science, Engineering and Medicine > Engineering > Engineering | ||||||
Journal or Publication Title: | Endoscopy | ||||||
Publisher: | Georg Thieme Verlag | ||||||
ISSN: | 1438-8812 | ||||||
Official Date: | 8 July 2022 | ||||||
Dates: |
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Volume: | 54 | ||||||
Number: | 12 | ||||||
Page Range: | pp. 1158-1168 | ||||||
DOI: | 10.1055/a-1831-5385 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Restricted or Subscription Access |
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