Endoscopic ultrasound-guided parenchymal liver biopsy: a systematic review and meta-analysis

Baran, Bülent; Kale, Santosh; Patil, Prithvi; Kannadath, Bijun S.; Ramireddy, Srinivas; Badillo, Ricardo; DaVee, Roy Tomas; Thosani, Nirav

doi:10.1007/s00464-020-08053-x

Cited by 31 publications

(33 citation statements)

References 52 publications

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“…EUS fine-needle aspiration (FNA) and fine-needle biopsy (FNB) are a well-established diagnostic approach and are being employed for years for targeting both focal lesions and parenchymal liver disease [ 4 , 5 ]. To this end, many studies evaluating different needles on random liver biopsies have found superior results with FNB compared to FNA [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Yield of Endoscopic Ultrasound-Guided Liver Biopsy in Comparison to Percutaneous Liver Biopsy: A Two-Center Experience

Facciorusso

Ramai

Bellocchi³

et al. 2021

Cancers

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There is scarce and conflicting evidence on the comparison between endoscopic ultrasound (EUS) and percutaneous (PC)-guided liver biopsy (LB). The aim of this study was to compare the two approaches in a series of patients with parenchymal and focal liver lesions. Fifty-four patients undergoing EUS-LB in two high-volume centers between 2017 and 2021 were compared to 62 patients who underwent PC-LB. The primary outcome was diagnostic adequacy rate. The secondary outcomes were diagnostic accuracy, total sample length (TSL), number of complete portal tracts (CPTs), procedural duration, and adverse events. Variables were compared using the Chi-square and Mann–Whitney test. Median age was 56 years (interquartile range 48–69) in the EUS-LB group and 54 years (45–67) in the PC-LB group with most patients being male. Indication for LB was due to parenchymal disease in 50% of patients, whereas the other patients underwent LB due to focal liver lesions. Diagnostic adequacy was 100% in PC-LB and 94.4% in the EUS-LB group (p = 0.74), whereas diagnostic accuracy was 88.8% in the EUS-LB group and 100% in the PC-LB group (p = 0.82). Median TSL was significantly greater in the PC-LB group (27.4 mm, IQR 21–29) when compared to the EUS-LB group (18.5 mm, 10.1–22.4; p = 0.02). The number of complete portal tracts was 21 (11–24) in the PC-LB group and 18.5 (10–23.2) in EUS-LB group (p = 0.09). EUS-LB was a significantly longer procedure (7 min, 5–11 versus 1 min, 1–3 of PC-LB; p < 0.001) and no evidence of adverse events was observed in any of the study groups. These results were confirmed in the subgroup analysis performed according to an indication for LB (parenchymal disease versus focal lesion). Although PC-LB yielded specimens with greater TSL, diagnostic adequacy and accuracy were similar between the two procedures.

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Section: Introductionmentioning

confidence: 99%

Diagnostic Yield of Endoscopic Ultrasound-Guided Liver Biopsy in Comparison to Percutaneous Liver Biopsy: A Two-Center Experience

Facciorusso

Ramai

Bellocchi³

et al. 2021

Cancers

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“…Ultrasound-guided PLB, which is a safe, simple, and reliable biopsy method, has been established as a basic procedure for PLB [ 2 , 13 , 14 ]. Furthermore, in patients with severe obesity in whom it is difficult to visualize the liver on ultrasound, PLB can be technically difficult to perform and endoscopic ultrasound guided liver biopsy (EUS-LB) may be selected [ 15 , 16 ]. However, in patients with accumulations of ascites, hepatic failure, blood dyscrasia, or those with severe coagulation abnormalities due to oral drugs or other reasons showing bleeding tendencies, PLB or EUS-LB is more likely to cause prolonged intra-abdominal bleeding and, since there are no non-invasive measures to stop the bleeding, these patients are in general contraindicated.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and Safety of Transjugular Liver Biopsy for Japanese Patients with Chronic Liver Diseases

et al. 2021

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Background and study aim: Transjugular liver biopsy (TJLB) can be used in patients who are ineligible for percutaneous liver biopsy (PLB) with acute and chronic hepatic disease. This study aimed to evaluate the usefulness and safety of TJLB in patients who were not indicated for PLB. Methods: Between July 2014 and February 2019, a total of 134 patients underwent liver biopsies at our institution. Among these, PLB was performed in 110 patients and TJLB in 24 patients. A retrospective comparison of clinical results in these patients was then performed. The primary endpoints of this study were the utility and safety of TJLB in patients who were not indicated for PLB. Results: The procedural success rate was 100% in both groups. The clinical response rate and the effective tissue sampling rate were 100% in the TJLB group and 97% in the PLB group (p = 0.55). There was no difference in the number of portal fields examined retrospectively between the two groups. No serious adverse events were observed in either group. Conclusions: It is suggested that TJLB is useful because it can be safely performed in patients with poor general condition who are not indicated for PLB.

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“…A discrepancy in the literature exists regarding the superiority of FNA versus FNB needles based on the most recent meta-analyses available. [5][6][7][8] However, data may favor FNB needles in terms of diagnostic yield. In a meta-analysis by Khan et al, 7 diagnostic yield was similar between FNA and FNB needles only when FNA was accompanied by rapid onsite evaluation of the specimen.…”

Section: Eus-lbmentioning

confidence: 99%

“…In a meta-analysis by Khan et al, 7 diagnostic yield was similar between FNA and FNB needles only when FNA was accompanied by rapid onsite evaluation of the specimen. In addition, a 2020 metaanalysis by Baran et al 8 found that FNB needles yielded a higher number of complete portal tracts.…”

Section: Eus-lbmentioning

confidence: 99%

Endoscopic ultrasound–guided liver biopsy: needle types and suction methods

et al. 2021

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Endoscopic ultrasound-guided parenchymal liver biopsy: a systematic review and meta-analysis

Cited by 31 publications

References 52 publications

Diagnostic Yield of Endoscopic Ultrasound-Guided Liver Biopsy in Comparison to Percutaneous Liver Biopsy: A Two-Center Experience

Diagnostic Yield of Endoscopic Ultrasound-Guided Liver Biopsy in Comparison to Percutaneous Liver Biopsy: A Two-Center Experience

Feasibility and Safety of Transjugular Liver Biopsy for Japanese Patients with Chronic Liver Diseases

Endoscopic ultrasound–guided liver biopsy: needle types and suction methods

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