Outcomes
cholangitis, malignancy, benign disease, perforation, gastro-intestinal bleeding
METASTASIS, CHOLANGITIS, ADVERSE EVENTS, ADVERSE EVENT, PANCREATITIS
The primary outcome was sensitivity, defined as brush cytology specimen showing at least suspicion of malignancy (Bethesda ≥ 4) in patients with malignant diagnosis, as confirmed by histopathology results (surgical specimen or biopsy of either the primary mass or distant metastasis) or cytopathology results (ultrasound-or computed tomography (CT)-guided fine needle aspiration of distant metastasis or endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA) of the primary mass) showing at least suspicion of malignancy, or clinical and/or radiological follow-up. Secondary endpoints were specificity (defined as Bethesda ≤ 3 in patients with benign disease), positive predictive value (PPV, defined as the rate of true-positive results among all positive tests), negative predictive value (NPV, defined as the rate of true-negative results among all negative test results), and adverse events. Adverse events were classified according to the Cotton criteria (pancreatitis, gastro-intestinal bleeding, perforation, and cholangitis) [