{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T23:52:25Z","timestamp":1791849145007,"version":"4.3.4"},"reference-count":25,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Accurate staging is crucial for managing cholangiocarcinoma (CCA). Endoscopic ultrasound with tissue acquisition (EUS-TA) may enhance cross-sectional imaging-based staging; however, the impact of EUS on CCA management decision-making is unclear.<\/jats:p>\n                  <jats:p>6 electronic databases were searched through to 10 July 2025 for studies on EUS-TA in staging CCA cases eligible for surgical resection or liver transplantation. The primary outcome was the pooled proportion of patients excluded from curative-intent surgery based on the EUS findings, which included newly detected findings and confirmation by EUS-TA of cross-sectional imaging findings. Secondary outcomes included the pooled incremental benefit of EUS (IBEUS) over cross-sectional imaging and EUS-specific adverse events. The IBEUS was defined as the proportion of patients with malignant lymph nodes identified by EUS-TA but not by cross-sectional imaging, relative to all patients who underwent cross-sectional imaging.<\/jats:p>\n                  <jats:p>9 studies with 831 patients were included. The rate of exclusion from curative-intent surgery based on EUS findings was 10% overall (95%CI 6%\u201318%; 9 studies), 7% for perihilar CCA (pCCA; 95%CI 2%\u201319%; 5 studies), 10% for those planned for resection (95%CI 4%\u201322%; 5 studies), and 8% for those planned for transplantation (95%CI 3%\u201322%; 3 studies). The pooled IBEUS was 3% (95%CI 1%\u201310%; 5 studies) overall, 4% (95%CI 1%\u201317%; 3 studies) for pCCA, 1% (95%CI 0%\u20133%; 2 studies) in patients intended for operative resection, and 7% (95%CI 1%\u201326%; 2 studies) in those intended for transplantation.<\/jats:p>\n                  <jats:p>EUS may impact CCA staging and support treatment decisions.<\/jats:p>","DOI":"10.1055\/a-2944-4167","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T23:14:57Z","timestamp":1787786097000},"source":"Crossref","is-referenced-by-count":0,"title":["Impact of endoscopic ultrasound in cholangiocarcinoma staging: a systematic review and meta-analysis"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6293-8506","authenticated-orcid":false,"given":"Nasruddin","family":"Sabrie","sequence":"additional","affiliation":[{"name":"University of Toronto, Canada","place":["Toronto"],"department":["Gastroenterology and Hepatology, Department of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8463-6601","authenticated-orcid":false,"given":"Michael","family":"Youssef","sequence":"additional","affiliation":[{"name":"University of Toronto, Canada","place":["Toronto"],"department":["Gastroenterology and Hepatology, Department of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yibing","family":"Ruan","sequence":"additional","affiliation":[{"name":"University of Calgary, Canada","place":["Calgary"],"department":["Oncology"]},{"name":"Cancer Control Alberta, Canada","place":["Calgary"],"department":["Cancer Epidemiology and Prevention Research"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Vaska","sequence":"additional","affiliation":[{"name":"Alberta Health Services, Canada","place":["Calgary"],"department":["Knowledge Resource Service"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir C.","family":"Grover","sequence":"additional","affiliation":[{"name":"Scarborough Health Network, Canada","place":["Toronto"],"department":["Research Institute"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul D.","family":"James","sequence":"additional","affiliation":[{"name":"The University Health Network, Canada","place":["Toronto"],"department":["Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6966-3908","authenticated-orcid":false,"given":"Nauzer","family":"Forbes","sequence":"additional","affiliation":[{"name":"University of Calgary, Canada","place":["Calgary"],"department":["Division of Gastroenterology and Hepatology"]},{"name":"University of Calgary, Canada","place":["Calgary"],"department":["Community Health Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6209-9905","authenticated-orcid":false,"given":"Vinay","family":"Chandrasekhara","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Minnesota, United States","place":["Rochester"],"department":["Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydi M. J. W.","family":"van Driel","sequence":"additional","affiliation":[{"name":"Erasmus MC University Medical Center Rotterdam, Netherlands","place":["Rotterdam"],"department":["Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5068-8227","authenticated-orcid":false,"given":"David M.","family":"de Jong","sequence":"additional","affiliation":[{"name":"Erasmus MC University Medical Center Rotterdam, Netherlands","place":["Rotterdam"],"department":["Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5090-7685","authenticated-orcid":false,"given":"Rishad","family":"Khan","sequence":"additional","affiliation":[{"name":"University of Calgary, Canada","place":["Calgary"],"department":["Division of Gastroenterology and 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