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CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(12): E1850-E1854
DOI: 10.1055/a-1274-9763
Original article

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

Neil Bhogal
1   Division of Gastroenterology & Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, United States
,
Bernadette Lamb
2   Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE
,
Benjamin Arbeiter
2   Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE
,
Sarah Malik
1   Division of Gastroenterology & Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, United States
,
Harlan Sayles
3   Department of Biostatistics, College of Public Health. University of Nebraska Medical Center, Nebraska, United States
,
Audrey J. Lazenby
4   Department of Pathology & Microbiology, University of Nebraska Medical Center, Omaha, Nebraska, United States
,
Saurabh Chandan
1   Division of Gastroenterology & Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, United States
,
Amaninder Dhaliwal
1   Division of Gastroenterology & Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, United States
,
Shailender Singh
1   Division of Gastroenterology & Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, United States
,
Ishfaq Bhat
1   Division of Gastroenterology & Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, United States
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Abstract

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.



Publication History

Received: 21 May 2020

Accepted: 07 August 2020

Article published online:
17 November 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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