Endoscopic ultrasound guided liver biopsy for parenchymal liver disease

Shah, Aun R.; Al-Hanayneh, Muhannad; Chowdhry, Monica; Bilal, Mohammad; Singh, Shailendra

doi:10.4254/wjh.v11.i4.335

Cited by 24 publications

(29 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Advantages of this technique include ability to perform hepatic venous pressure gradient measurements simultaneously and comparatively less complications [17,18]. However, TJ-LB confers higher cost than PC-LB, requires more technical skill, and is more time-consuming [17,19]. Levy et al first described using EUS-LB for hepatic tissue acquisition using a disposable 19G Trucut needle (EUS-TCB, QuickCore, Wilson-Cook) [20].…”

Section: Discussionmentioning

confidence: 99%

Safety and adequacy of endoscopic ultrasound-guided random liver biopsy in comparison with transjugular and percutaneous approaches

et al. 2020

View full text Add to dashboard Cite

Background and study aims Endoscopic ultrasound-guided liver biopsy (EUS-LB) is an accepted technique for tissue acquisition. Traditionally, random LB has been performed with percutaneous (PC-LB) and transjugular (TJ-LB) approaches. The purpose of this study was to compare the safety profile and efficacy of EUS-LB, PC-LB, and TJ-LB. Patients and methods A retrospective analysis was performed at a tertiary academic medical center. Inclusion criteria for analysis were all adult patients who underwent EUS-LB since inception and TJ-LB/PC-LB over a 3-year span (June 2016 to June 2019). The primary outcome assessed was any adverse events. Secondary outcomes included technical success resulting in tissue acquisition and diagnostic adequacy of the sample for histologic analysis. Results A total of 513 patients were included for analysis. There were 135 EUS-LB, 287 PC-LB, and 91 TJ-LB. The most common indication for LB was abnormal liver function tests. For the primary outcome, the rate of adverse events was low with five reported (< 1 %). There were two in the EUS-LB group, two in the PC-LB group, and one in TJ-LB group, and this difference was not statistically significant (P = 0.585). The technical success rate was 100 % in each group. The rate of diagnostic adequacy was 100 % in TJ-LB group and 99 % in both EUS-LB and PC-LB groups. This difference was not statistically significant (P = 1.000). The most common histologic finding was non-specific changes (33.7 %) followed by non-alcoholic steatohepatitis (15.60 %). Conclusion In comparison with PC-LB and TJ-LB, EUS-LB has comparable safety profile, technical success rate, and diagnostic adequacy. EUS-LB should be considered as an option for random liver biopsy.

show abstract

Section: Discussionmentioning

confidence: 99%

Safety and adequacy of endoscopic ultrasound-guided random liver biopsy in comparison with transjugular and percutaneous approaches

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Evidence suggests the superiority of EUS-LB for a targeted approach of focal lesions, with less sampling variability in heterogeneous parenchymal disease. 133 Mohan and colleagues 134 recently published an analysis of a systematic review and meta-analysis of reports of complications of EUS-guided liver biopsy. Of the nine study arms with 437 patients, the pooled rate of adverse events with EUS-LB was 2.3% (95% CI 1.1% to 4.8%, I 2 =0).…”

Section: Percutaneous Biopsymentioning

confidence: 99%

Guidelines on the use of liver biopsy in clinical practice from the British Society of Gastroenterology, the Royal College of Radiologists and the Royal College of Pathology

Neuberger

Patel

Caldwell

et al. 2020

Gut

230

201

View full text Add to dashboard Cite

Liver biopsy is required when clinically important information about the diagnosis, prognosis or management of a patient cannot be obtained by safer means, or for research purposes. There are several approaches to liver biopsy but predominantly percutaneous or transvenous approaches are used. A wide choice of needles is available and the approach and type of needle used will depend on the clinical state of the patient and local expertise but, for non-lesional biopsies, a 16-gauge needle is recommended. Many patients with liver disease will have abnormal laboratory coagulation tests or receive anticoagulation or antiplatelet medication. A greater understanding of the changes in haemostasis in liver disease allows for a more rational, evidence-based approach to peri-biopsy management. Overall, liver biopsy is safe but there is a small morbidity and a very small mortality so patients must be fully counselled. The specimen must be of sufficient size for histopathological interpretation. Communication with the histopathologist, with access to relevant clinical information and the results of other investigations, is essential for the generation of a clinically useful report.

show abstract

“…EUS-guided liver biopsy (EUS-LB) has gained a great popularity since its first description and is currently considered to have at least the same efficacy compared to the traditional methods of performing liver biopsy from focal lesions [29]. EUS-LB has several advantages over the percutaneous and trans-jugular routes, including better safety profile [30], real-time high quality imaging of both liver lobes, and enabling access to the target focal lesions, thus avoiding intervening blood vessels and adjacent structures, as well as providing a real-time detailed view of the biopsy needle route during tissue acquisition through the liver [31][32][33].…”

Section: Tissue Diagnosis Capabilitymentioning

confidence: 99%

A Comprehensive Narrative Review on the Evolving Role of Endoscopic Ultrasound in Focal Solid Liver Lesions Diagnosis and Management

et al. 2020

View full text Add to dashboard Cite

The implications of endoscopic ultrasound (EUS) have expanded considerably in recent years to cover more fields in invasive gastroenterology practice, as both an investigative and therapeutic modality. The utility of EUS in the diagnosis and management of focal liver lesions has gained a special attractiveness recently. The EUS probe proximity to the liver and its excellent spatial resolution enables real-time images coupled with several enhancement techniques, such as contrast-enhanced (CE) EUS. Aside from its notable capability to execute targeted biopsies and therapeutic interventions, EUS has developed into a hopeful therapeutic tool for the management of solid liver lesions. Herein, we provide a comprehensive state-of-the-art review on the efficacy and safety of EUS in the diagnosis and management of focal solid liver lesions. Medline/PubMed and Embase database searches were conducted by two separate authors (T.K. and W.S.), all relevant studies were assessed, and relevant data was extracted and fully reported. EUS-guided diagnosis of focal liver lesions by sonographic morphologic appearance and cytological and histopathological finding of biopsies obtained via fine needle aspiration/biopsy have been shown to significantly improve the diagnosis of solid liver lesions compared with traditional imaging tools. Similarly, EUS-guided treatment has been shown to consistently have excellent technical success, high efficacy, and minor adverse events. The evolving valuable evidences of EUS utility might satisfy the unmet need of optimizing management of focal solid liver lesions.

show abstract

Endoscopic ultrasound guided liver biopsy for parenchymal liver disease

Cited by 24 publications

References 51 publications

Safety and adequacy of endoscopic ultrasound-guided random liver biopsy in comparison with transjugular and percutaneous approaches

Safety and adequacy of endoscopic ultrasound-guided random liver biopsy in comparison with transjugular and percutaneous approaches

Guidelines on the use of liver biopsy in clinical practice from the British Society of Gastroenterology, the Royal College of Radiologists and the Royal College of Pathology

A Comprehensive Narrative Review on the Evolving Role of Endoscopic Ultrasound in Focal Solid Liver Lesions Diagnosis and Management

Contact Info

Product

Resources

About