Endoscopy 2019; 51(09): 818-824
DOI: 10.1055/a-0967-3640
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic ultrasound-guided liver biopsy using a 22-G fine needle biopsy needle: a prospective study

Muhammad K. Hasan
1  Center for Interventional Endoscopy, AdventHealth Orlando, Florida, USA
,
Kambiz Kadkhodayan
1  Center for Interventional Endoscopy, AdventHealth Orlando, Florida, USA
,
Evgeny Idrisov
2  Department of Internal Medicine, AdventHealth Orlando, Florida, USA
,
Saeed Ali
2  Department of Internal Medicine, AdventHealth Orlando, Florida, USA
,
Ehsan Rafiq
3  Department of Gastroenterology and Hepatology, AdventHealth Orlando, Florida, USA
,
Dana Ben-Ami Shor
1  Center for Interventional Endoscopy, AdventHealth Orlando, Florida, USA
4  Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
,
Ala Abdel-Jalil
1  Center for Interventional Endoscopy, AdventHealth Orlando, Florida, USA
,
Uday Navaneethan
1  Center for Interventional Endoscopy, AdventHealth Orlando, Florida, USA
,
Ji Bang
1  Center for Interventional Endoscopy, AdventHealth Orlando, Florida, USA
,
Shyam Varadarajulu
1  Center for Interventional Endoscopy, AdventHealth Orlando, Florida, USA
,
Robert Hawes
1  Center for Interventional Endoscopy, AdventHealth Orlando, Florida, USA
,
Peter Pernicone
5  Department of Pathology, AdventHealth Orlando, Florida, USA
› Author Affiliations
Further Information

Publication History

submitted 24 February 2019

accepted after revision 16 May 2019

Publication Date:
31 July 2019 (online)

Abstract

Background Endoscopic ultrasound-guided liver biopsy (EUS-LB) using a 19-gauge (19-G) EUS needle is becoming increasingly popular. We evaluated the efficacy and safety of a 22-G EUS fine needle biopsy (FNB) needle for performing EUS-LB.

Methods Patients referred for evaluation of elevated liver enzymes and without obstructive disease requiring endoscopic retrograde cholangiopancreatography (ERCP) were included. Using a 22-G FNB needle, two passes were made from the left lobe and one from the right. The main outcome measure was adequacy of the specimen for histology interpretation, and the secondary outcome was the safety of EUS-guided liver biopsy with a 22-G FNB needle. Patients were followed for post-procedure complications for 30 days.

Results 40 patients (median age 61 years; 26 women) underwent EUS-LB. Analyzing by needle passes, the median longest core fragment was 12 mm (1st quartile – 3rd quartile 10 mm – 16.25 mm, interquartile range [IQR] 6.25 mm) from the left lobe and 11 mm (10 mm – 15.75 mm, IQR 5.75 mm) from the right lobe. The median cumulative core length per patient was 55 mm (44.5 mm – 68 mm, IQR 23.5 mm). The median cumulative number of complete portal triads (CPTs) per patient was 42 (28.5 – 53, IQR 24.5). The specimen was considered adequate in all 40 patients (100 %). Self-limiting abdominal pain was reported in 6 patients (15 %).

Conclusions EUS-LB using a 22-G FNB needle is a safe and viable alternative to the use of larger gauge needles, yielding adequate tissue for evaluation of parenchymal disease in 100 % of the patients.