Endoscopic retrograde cholangiopancreatography guided interventions in the management of pancreatic cancer

Table 1 Prospective/retrospective studies comparing the overall yield of endoscopic ultrasound and endoscopic retrograde cholangiopancreatography in the diagnosis of pancreatic cancer

Ref.	Year	No. of patients	No. of patients with pancreatic cancer	Diagnostic yield of EUS		Diagnostic yield of ERCP
				Sensitivity (%)	Specificity (%)	Sensitivity (%)	Specificity (%)
Moura et al[10]	2018	50	48	94	100	60	100
Weilert et al[11]	2014	51	34	94	100	50	100
Oppong et al[12]	2010	37	32	53	100	29	100
Ross et al[13]	2008	114	68	83	100	13	100
Wakatsuki et al[14]	2005	83	68	93	100	33	100
Rösch et al[15]	2004	50	16	43	100	54	100
Glasbrenner et al[16]	2000	95	50	78	93	81	88
Cellier et al[17]	1998	41	41	55	90	78	75
Total	-	521	357	811	1001	521	1001

Decimal numbers are rounded off.

¹Median. EUS: Endoscopic ultrasound; ERCP: Endoscopic retrograde cholangiopancreatography.

Table 2 Prospective/retrospective studies on the diagnostic yield of endoscopic retrograde cholangiopancreatography guided brush cytology for malignant biliary stricture

Ref.	Year	No. of patients	No of patients with malignant strictures	TP on brush cytology	Sensitivity (%)	Specificity (%)	PPV (%)	NPV (%)
Moura et al[10]	2018	50	48	40	40	100	100	7
Agarwal et al[21]	2018	40	40	27	68	NA	NA	NA
Sethi et al[33]	2016	162	106	58	55	100	100	54
Shieh et al[22]	2014	32	32	25	78	NA	NA	NA
Weber et al[36]	2008	58	58	24	41	NA	NA	NA
Kitajima et al[37]	2007	60	NA	NA	72	100	NA	NA
Fogel et al[23]	2006	102	94	28	30	NA	NA	NA
Rösch et al[15]	2004	50	28	28	46	100	NA	NA
Stewart et al[24]	2001	406	246	147	60	98	98	61
Macken et al[25]	2000	106	62	35	57	100	100	62
Jailwala et al[26]	2000	133	104	31	30	100	100	28
Glasbrenner et al[27]	1999	78	57	32	56	91	94	43
Mansfield et al[28]	1997	54	52	17	54	100	100	8
Sugiyama et al[35]	1996	43	31	25	48	100	NA	NA
Pugliese et al[29]	1995	94	64	35	54	100	100	50
Ponchon et al[30]	1995	210	128	45	35	97	96	44
Lee et al[31]	1995	149	106	40	37	100	100	39
Foutch et al[32]	1991	30	17	06	33	100	100	58
Pugliese et al[34]	1987	22	12	08	66	88	NA	NA
Total	-	1879	1285	651	541	1001	-	-

¹Median value of available data. TP: True positive; PPV: Positive predictive value; NPV: Negative predictive value; NA: Data not available. Decimal numbers are rounded off.

Table 3 Prospective/retrospective studies on the diagnostic yield of fluoroscopic guided endobiliary forceps biopsy for malignant biliary stricture

Ref.	Year	No. of patients	No of patients with malignant strictures	TP on forceps biopsy	Sensitivity (%)	Specificity (%)	PPV (%)	NPV (%)
Moura et al[10]	2018	50	48	40	44	100	100	7
Tanaka et al[47]	2018	123	123	80	65	NA	NA	NA
Naitoh et al[48]	2016	208	160	97	61	100	100	43.2
Chen et al[49]	2016	79	65	35	54	100	100	31.82
Nishikawa et al[50]	2014	72	64	32	50	96	97	40.7
Kawashima et al[51]	2012	61	34	26	76	100	NA	NA
Hartman et al[41]	2012	81	38	30	76	100	100	81
Draganov et al[42]	2012	26	17	5	29	100	100	43
Wright et al[43]	2011	133	117	84	72	100	100	36
Weber et al[36]	2008	58	58	31	53	NA	NA	NA
Kitajima et al[37]	2007	60	NA	NA	62	100	NA	NA
Rösch et al[15]	2004	50	28	28	36	100	NA	NA
Jailwala et al[26]	2000	133	104	48	43	90	94	31
Schoefl et al[44]	1997	103	58	38	65	100	100	69
Sugiyama et al[35]	1996	43	31	25	81	100	100	67
Ponchon et al[30]	1995	128	82	35	43	97	97	41
Pugliese et al[29]	1995	52	36	19	53	100	100	48
Kubota et al[45]	1993	41	32	26	81	100	100	75
Pugliese et al[34]	1987	22	06	06	100	100	NA	NA
Total	-	1453	1101	685	611	1001	-	-

¹Median value of available data. Decimal numbers are rounded off. TP: True positive; PPV: Positive predictive value; NPV: Negative predictive value; NA: Data not available.

Table 4 Randomized controlled trials and retrospective studies comparing covered with un-covered biliary self-expanding metal stents for malignant distal biliary obstruction

Ref.	Year	Study design	Type of stent	No. of patients	Pancreatic malignancy (%)	Stent patency (d)	Patient survival (d)	No. of stent dysfunction	No. of complications
Seo et al[15]	2019	RCT	Uncovered, Covered	60, 59	100	NA, NA	NA, NA	101, 0	12, 14
Conio et al[88]	2018	RCT	Uncovered, Covered	80, 78	72.5, 75.6	541 (Median)1, 240 (Median)	112 (Median), 134 (Median)	10, 12	10, 19
Flores-Carmona et al[89]	2016	RCT	Uncovered, Covered	46, 22	52.5, 50	NA, NA	NA, NA	4, 3	NA, NA
Mangiavillano et al[90]	2015	RCT	Uncovered, Covered	21, 23	NA	194 (Median)1, 89 (Median)	NA, NA	NA, NA	1, 1
Lee SJ et al[91]	2014	RCT	Uncovered, Covered	20, 20	30, 60	413.3 ± 63 (mean ± SD)1, 207.5 ± 46 (mean ± SD)	359.9 ± 61.5 (mean ± SD), 350.5 ± 43.8 (mean ± SD)	41, 10	0, 3
Ung et al[92]	2013	RCT	Uncovered, Covered	34, 34	79, 88	127 (Median), 153 (Median)	157 (Median), 154 (Median)	NA, NA	0, 2
Kitano et al[93]	2013	RCT	Uncovered, Covered	60, 60	100, 100	166.9 ± 124.9 (mean ± SD)1, 219.3 ± 159.1 (mean ± SD)	223 (Median), 285(Median)	22, 14	2, 2
Fukuda et al[94]	2012	RCT	Uncovered, Covered	71, 72	84.5, 83.3	314 (Median)1, 552(Median)	NA, NA	23, 17	NA, NA
Krokidis et al[95]	2011	RCT	Uncovered, Covered	40, 40	100, 100	166.0 ± 82.8 (mean ± SD)1, 234.0 ± 132 (mean ± SD)	203.2 ± 74.8 (Median ± SD), 247.0 ± 126.7 (Median ± SD)	121, 4	4, 5
Krokidis et al[96]	2010	RCT	Uncovered, Covered	30, 30	0, 0	166.0 ± 87.7 (mean ± SD)1, 227.3 ± 139.7 (mean ± SD)	180.5 ± 82.6 (Median ± SD), 243.5.0 ± 141.1 (Median ± SD)	101, 4	4, 3
Kullman et al[97]	2010	RCT	Uncovered, Covered	200, 200	77, 76	154 (Mean), 199 (Mean)	174 (Median), 116 (Median)	45, 47	20, 14
Telford et al[98]	2010	RCT	Uncovered, Covered	61, 68	77, 86	711 (Median), 357 (Median)	239 (Median), 227 (Median)	121, 23	271, 48
Cho et al[99]	2009	RCT	Uncovered, Covered	38, 39	NA	195 (Median), 227 (Median)	NA, NA	NA, NA	4, 10
Gonzalez-Huix et al[100]	2008	RCT	Uncovered, Covered	53, 61	58.5, 52.5	NA, NA	NA, NA	61, 8	141, 23
Yoon et al[46]	2006	Retrospective	Uncovered, Covered	41, 36	68.2, 86	319 (Mean), 398 (Mean)	308 ± 42 (mean ± SD), 392 ± 60 (mean ± SD)	111, 15	1, 4
Park et al[101]	2006	Retrospective	Uncovered, Covered	108, 98	65.7, 54.1	143.5 (Mean), 148.9 (Mean)	207 (Mean), 209 (Mean)	20, 21	3, 17
Isayama et al[102]	2004	RCT	Uncovered, Covered	55, 57	58.2, 59.6	193 (Mean)1, 225 (Mean)	237 (Mean), 255 (Mean)	211, 8	3, 8
Lee et al[103]	2004	RCT	Uncovered, Covered	21, 22	38.1, 40.9	127 (Median)1, 216 (Median)	NA, NA	11, 4	NA, NA
Smith et al[105]	1995	RCT	Uncovered, Covered	24, 22	70.1, 77.3	NA, NA	NA, NA	NA, NA	3, 3

¹Statistically significant data; RCT: Randomized controlled trial; NA: Data not available.