EUS-guided fine-needle core liver biopsy with a modified one-pass, one-actuation wet suction technique comparing two types of EUS core needles

Nieto, José; Dawod, Enad; Deshmukh, Ameya; Penn, Eli; Adler, Douglas G.; Saab, Sammy

doi:10.1055/a-1165-1767

Cited by 23 publications

(19 citation statements)

References 22 publications

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“…Recently, 19gauge fork-tip and franseen FNB needles have become commercially available. In a large retrospective study using fork-tip and franseen FNB needles, Nieto and colleagues reported post-procedure abdominal pain occurred in 17% of patients 12 . Hasan et al reported 100% specimen adequacy when three biopsies were obtained using a 22-gauge FNB needle, but post-procedure pain occurred in 15% of patients 13 .…”

Section: Resultsmentioning

confidence: 99%

Comparison of Two EUS-Guided Liver Biopsy Techniques (“Wet Heparin” and “Wet Saline”) For Benign Parenchymal Liver Disease

Saraireh

Abdelfattah

Hassouneh

et al. 2021

Preprint

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Background: Endoscopic ultrasound-guided liver biopsy (EUS-LB) has emerged as a viable mean to obtain core tissue. Different wet suction techniques using saline or heparin have been described. We aimed to compare tissue adequacy with the “wet saline” (WS) technique compared to the “wet heparin” (WH) technique.Methods: We conducted a retrospective review of patients who underwent EUS-LB and Percutaneous liver biopsy (PLB-LB) for benign parenchymal liver disease between May 2017 to October 2019. All procedures were performed at a single tertiary Veterans Affairs Medical Center (VAMC).Results: A total of 257 biopsies from 217 patients were included. Among the 102 EUS-LB specimens, 53 were obtained using WS technique and 49 were obtained using WH technique. Specimen adequacy was similar in the both groups. Median ASL and length of longest piece did not differ significantly between both groups. Clots were present more frequently in the WS group. Among patients who underwent EUS-LB of both right and left liver lobes, an adequate biopsy was obtained in 85% of patients in the WS group and 96% of patients in the WH group. EUS-LB showed lower risk of post procedural pain and complication rates when compared with percutaneous liver biopsy (PLB). To our knowledge, this is the first study to compare diagnostic accuracy between WH and WS EUS-LB techniques, and to compare post-procedure pain between EUS-LB and moderate sedation PLB. WH-EUS-LB may be preferable to WS because of fewer clots in the specimen. Prospective studies are needed to further verify these findings.

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Section: Resultsmentioning

confidence: 99%

Comparison of Two EUS-Guided Liver Biopsy Techniques (“Wet Heparin” and “Wet Saline”) For Benign Parenchymal Liver Disease

Saraireh

Abdelfattah

Hassouneh

et al. 2021

Preprint

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“…), has been demonstrated to be a safe method with high histologic yields in adult patients (11). The Franseen needle seems to be more adequate of obtaining liver tissue than a fork-tip needle in adults, however additional studies need to be conducted to assess for this difference to extend to pediatric patient populations (12).…”

Section: Eus-modified Lb (Eus-(m)lbmentioning

confidence: 99%

EUS-guided fine-needle liver biopsy in pediatric patients using a modified technique with one-pass, one-actuation wet suction

Tejedor-Tejada¹,

Nieto²,

Deshmukh³

et al. 2022

Rev Esp Enferm Dig

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Background and aims:Liver biopsy (LB) can be a valuable tool to determine the etiology of pediatric liver disease. There is limited data of the role of EUS-LB in children. We have evaluated the efficacy and the safety of a modified technique (M)LB in high risk of bleeding or obese children. Additionally, we aimed to compare the tissue yield of EUS-(M)LB and percutaneous (PC) approach. Methods:A retrospective analysis comparing EUS-(M)LB and PC-LB in children at a tertiary referral center. All consecutive children referred for PC-LB and EUS-LB who had an unexplained liver test abnormality after exclusion of biliary disorders from march-2017 to August-2018 were included. EUS-(M)LB consists of a one pass wet suction technique using a 19-gauche core needle. Comparison between total specimen length (TSL) and number of complete portal triads (CPTs) were performed. Results:There were 28 EUS-(M)LB and 28 PC-LB pediatric cases. The median (IQR) age was 14.5 years (13.4-16). The median TSL was 8.6 (5.8-9.6) in EUS-(M)LB cases and 7 cm (7-9) in PC-LB cases (P =0.788). The maximum intact specimen was 2.8 cm (EUS-(M)LB) and 1.6 cm (PC-LB) (P =0.009). The mean (SD) number of CPTs per sample was 28.2 (7.3) and 11.6 (2.1), respectively (P =0.001). Adverse events included once case of self-limited abdominal pain in the PC-LB group. Conclusion:EUS-(M)LB has the potential to be a safe and effective alternative diagnostic modality, at when compared to PC-LB, to evaluate children with unexplained liver test abnormalities who undergo EUS to evaluate biliary disorders.

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“…Since the study by Aggarwal et al 7 was begun, 2 other head-to-head comparisons of these 2 needles have been published. Nieto et al 14 completed a follow-up study that compared their fork-tip data with data from 210 subsequent patients who underwent identical-protocol EUS-LB with a Franseen needle. 14 The Franseen needle produced larger cores with a mean length of 3.1 cm, a total length of 6.5 cm, and a mean of 24 CPTs.…”

mentioning

confidence: 99%

“…Nieto et al 14 completed a follow-up study that compared their fork-tip data with data from 210 subsequent patients who underwent identical-protocol EUS-LB with a Franseen needle. 14 The Franseen needle produced larger cores with a mean length of 3.1 cm, a total length of 6.5 cm, and a mean of 24 CPTs. These were all significant at P < .02.…”

mentioning

confidence: 99%

The point of EUS-guided liver biopsy

Schembre

2021

Gastrointestinal Endoscopy

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EUS-guided fine-needle core liver biopsy with a modified one-pass, one-actuation wet suction technique comparing two types of EUS core needles

Cited by 23 publications

References 22 publications

Comparison of Two EUS-Guided Liver Biopsy Techniques (“Wet Heparin” and “Wet Saline”) For Benign Parenchymal Liver Disease

Comparison of Two EUS-Guided Liver Biopsy Techniques (“Wet Heparin” and “Wet Saline”) For Benign Parenchymal Liver Disease

EUS-guided fine-needle liver biopsy in pediatric patients using a modified technique with one-pass, one-actuation wet suction

The point of EUS-guided liver biopsy

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