Cargando…

Diagnostic performance of ultrasound in acute cholecystitis: a systematic review and meta-analysis

BACKGROUND: An updated overview of ultrasound (US) for diagnosis of acute cholecystitis (AC) remains lacking. This systematic review was conducted to evaluate the diagnostic performance of US for AC. METHODS: A systematic review was conducted following PRISMA guidelines. We meticulously screened art...

Descripción completa

Detalles Bibliográficos
Autores principales: Huang, Sih-Shiang, Lin, Kai-Wei, Liu, Kao-Lang, Wu, Yao-Ming, Lien, Wan-Ching, Wang, Hsiu-Po
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10687940/
https://www.ncbi.nlm.nih.gov/pubmed/38037062
http://dx.doi.org/10.1186/s13017-023-00524-5
_version_ 1785152077576536064
author Huang, Sih-Shiang
Lin, Kai-Wei
Liu, Kao-Lang
Wu, Yao-Ming
Lien, Wan-Ching
Wang, Hsiu-Po
author_facet Huang, Sih-Shiang
Lin, Kai-Wei
Liu, Kao-Lang
Wu, Yao-Ming
Lien, Wan-Ching
Wang, Hsiu-Po
author_sort Huang, Sih-Shiang
collection PubMed
description BACKGROUND: An updated overview of ultrasound (US) for diagnosis of acute cholecystitis (AC) remains lacking. This systematic review was conducted to evaluate the diagnostic performance of US for AC. METHODS: A systematic review was conducted following PRISMA guidelines. We meticulously screened articles from MEDLINE, Embase, and the Cochrane Library, spanning from inception to August 2023. We employed the search strategy combining the keywords "bedside US", "emergency US" or "point-of-care US" with "AC". Two reviewers independently screened the titles and abstracts of the retrieved articles to identify suitable studies. The inclusion criteria encompassed articles investigating the diagnostic performance of US for AC. Data regarding diagnostic performance, sonographers, and sonographic findings including the presence of gallstone, gallbladder (GB) wall thickness, peri-GB fluid, or sonographic Murphy sign were extracted, and a meta-analysis was executed. Case reports, editorials, and review articles were excluded, as well as studies focused on acalculous cholecystitis. The study quality was assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. RESULTS: Forty studies with 8,652 patients were included. The majority of studies had a low risk of bias and applicability concerns. US had a pooled sensitivity of 71% (95% CI, 69–72%), a specificity of 85% (95% CI, 84–86%), and an accuracy of 0.83 (95% CI, 0.82–0.83) for the diagnosis of AC. The pooled sensitivity and specificity were 71% (95% CI, 67–74%) and 92% (95% CI, 90–93%) performed by emergency physicians (EPs), 79% (95% CI, 71–85%) and 76% (95% CI, 69–81%) performed by surgeons, and 68% (95% CI 66–71%) and 87% (95% CI, 86–88%) performed by radiologists, respectively. There were no statistically significant differences among the three groups. CONCLUSION: US is a good imaging modality for the diagnosis of AC. EP-performed US has a similar diagnostic performance to radiologist-performed US. Further investigations would be needed to investigate the impact of US on expediting the management process and improving patient-centered outcomes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13017-023-00524-5.
format Online
Article
Text
id pubmed-10687940
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-106879402023-11-30 Diagnostic performance of ultrasound in acute cholecystitis: a systematic review and meta-analysis Huang, Sih-Shiang Lin, Kai-Wei Liu, Kao-Lang Wu, Yao-Ming Lien, Wan-Ching Wang, Hsiu-Po World J Emerg Surg Review BACKGROUND: An updated overview of ultrasound (US) for diagnosis of acute cholecystitis (AC) remains lacking. This systematic review was conducted to evaluate the diagnostic performance of US for AC. METHODS: A systematic review was conducted following PRISMA guidelines. We meticulously screened articles from MEDLINE, Embase, and the Cochrane Library, spanning from inception to August 2023. We employed the search strategy combining the keywords "bedside US", "emergency US" or "point-of-care US" with "AC". Two reviewers independently screened the titles and abstracts of the retrieved articles to identify suitable studies. The inclusion criteria encompassed articles investigating the diagnostic performance of US for AC. Data regarding diagnostic performance, sonographers, and sonographic findings including the presence of gallstone, gallbladder (GB) wall thickness, peri-GB fluid, or sonographic Murphy sign were extracted, and a meta-analysis was executed. Case reports, editorials, and review articles were excluded, as well as studies focused on acalculous cholecystitis. The study quality was assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. RESULTS: Forty studies with 8,652 patients were included. The majority of studies had a low risk of bias and applicability concerns. US had a pooled sensitivity of 71% (95% CI, 69–72%), a specificity of 85% (95% CI, 84–86%), and an accuracy of 0.83 (95% CI, 0.82–0.83) for the diagnosis of AC. The pooled sensitivity and specificity were 71% (95% CI, 67–74%) and 92% (95% CI, 90–93%) performed by emergency physicians (EPs), 79% (95% CI, 71–85%) and 76% (95% CI, 69–81%) performed by surgeons, and 68% (95% CI 66–71%) and 87% (95% CI, 86–88%) performed by radiologists, respectively. There were no statistically significant differences among the three groups. CONCLUSION: US is a good imaging modality for the diagnosis of AC. EP-performed US has a similar diagnostic performance to radiologist-performed US. Further investigations would be needed to investigate the impact of US on expediting the management process and improving patient-centered outcomes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13017-023-00524-5. BioMed Central 2023-11-30 /pmc/articles/PMC10687940/ /pubmed/38037062 http://dx.doi.org/10.1186/s13017-023-00524-5 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Review
Huang, Sih-Shiang
Lin, Kai-Wei
Liu, Kao-Lang
Wu, Yao-Ming
Lien, Wan-Ching
Wang, Hsiu-Po
Diagnostic performance of ultrasound in acute cholecystitis: a systematic review and meta-analysis
title Diagnostic performance of ultrasound in acute cholecystitis: a systematic review and meta-analysis
title_full Diagnostic performance of ultrasound in acute cholecystitis: a systematic review and meta-analysis
title_fullStr Diagnostic performance of ultrasound in acute cholecystitis: a systematic review and meta-analysis
title_full_unstemmed Diagnostic performance of ultrasound in acute cholecystitis: a systematic review and meta-analysis
title_short Diagnostic performance of ultrasound in acute cholecystitis: a systematic review and meta-analysis
title_sort diagnostic performance of ultrasound in acute cholecystitis: a systematic review and meta-analysis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10687940/
https://www.ncbi.nlm.nih.gov/pubmed/38037062
http://dx.doi.org/10.1186/s13017-023-00524-5
work_keys_str_mv AT huangsihshiang diagnosticperformanceofultrasoundinacutecholecystitisasystematicreviewandmetaanalysis
AT linkaiwei diagnosticperformanceofultrasoundinacutecholecystitisasystematicreviewandmetaanalysis
AT liukaolang diagnosticperformanceofultrasoundinacutecholecystitisasystematicreviewandmetaanalysis
AT wuyaoming diagnosticperformanceofultrasoundinacutecholecystitisasystematicreviewandmetaanalysis
AT lienwanching diagnosticperformanceofultrasoundinacutecholecystitisasystematicreviewandmetaanalysis
AT wanghsiupo diagnosticperformanceofultrasoundinacutecholecystitisasystematicreviewandmetaanalysis