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CC BY-NC-ND 4.0 · Endosc Int Open 2023; 11(02): E172-E178
DOI: 10.1055/a-1978-6652
Original article

EUS-guided left lobe liver biopsy: Safer modality with similar diagnostic yield as right lobe: a pilot study

Mithun Sharma
1   Asian Institute of Gastroenterology – Surgical Gastroenterology, Hyderabad, Telangana, India
,
Sundeep Lakhtakia
1   Asian Institute of Gastroenterology – Surgical Gastroenterology, Hyderabad, Telangana, India
,
Nitin Jagtap
1   Asian Institute of Gastroenterology – Surgical Gastroenterology, Hyderabad, Telangana, India
,
Anuradha Sekaran
1   Asian Institute of Gastroenterology – Surgical Gastroenterology, Hyderabad, Telangana, India
,
Rakesh Kalapala
1   Asian Institute of Gastroenterology – Surgical Gastroenterology, Hyderabad, Telangana, India
,
Basha Jahangeer
1   Asian Institute of Gastroenterology – Surgical Gastroenterology, Hyderabad, Telangana, India
,
Anand Kulkarni
1   Asian Institute of Gastroenterology – Surgical Gastroenterology, Hyderabad, Telangana, India
,
Mohan Ramchandani
1   Asian Institute of Gastroenterology – Surgical Gastroenterology, Hyderabad, Telangana, India
,
Rajesh Gupta
1   Asian Institute of Gastroenterology – Surgical Gastroenterology, Hyderabad, Telangana, India
,
Swapna Samudraala
1   Asian Institute of Gastroenterology – Surgical Gastroenterology, Hyderabad, Telangana, India
,
Juhi Khanna
1   Asian Institute of Gastroenterology – Surgical Gastroenterology, Hyderabad, Telangana, India
,
Padaki Nagaraja
1   Asian Institute of Gastroenterology – Surgical Gastroenterology, Hyderabad, Telangana, India
,
Sowmya Iyengar
1   Asian Institute of Gastroenterology – Surgical Gastroenterology, Hyderabad, Telangana, India
,
Baker Ali Gora
1   Asian Institute of Gastroenterology – Surgical Gastroenterology, Hyderabad, Telangana, India
,
Guduru Venkat Rao
1   Asian Institute of Gastroenterology – Surgical Gastroenterology, Hyderabad, Telangana, India
,
Nageshwar Reddy
1   Asian Institute of Gastroenterology – Surgical Gastroenterology, Hyderabad, Telangana, India
› Author Affiliations TRIAL REGISTRATION: Prospective study NCT04235855 at ClinicalTrials.gov (http://www.clinicaltrials.gov/)
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EUS-guided liver biopsy: the optimal technique?Endosc Int Open 2023; 11(02): E169-E171
DOI: 10.1055/a-1984-8006

Abstract

Background and study aims Percutaneous liver biopsy is traditionally done on the right lobe of the liver. Endoscopic ultrasound-guided liver biopsy (EUS-LB) can be performed on either the left or right lobe or as a combined bi-lobar biopsy. Earlier studies did not compare the benefit of bi-lobar biopsies to single-lobe biopsy for reaching a tissue diagnosis. The current study compared the degree of agreement of pathological diagnosis between the left lobe of the liver compared to right-lobe and with bi-lobar biopsy.

Patients and methods Fifty patients fulfilling the inclusion criteria were enrolled in the study. EUS-LB with a 22G core needle was performed separately on both the liver lobes. Three pathologists, who were blinded to the site of biopsy independently reviewed the liver biopsies. Sample adequacy, safety, and concordance of pathological diagnosis between left- and right-lobe biopsy of the liver were analyzed.

Results The pathological diagnosis was made in 96 % of patients. Specimen lengths from the left lobe and the right lobe were 2.31 ± 0.57 cm and 2.28 ± 0.69 cm, respectively (P = 0.476). The respective number of portal tracts were 11.84 ± 6.71 versus 9.58 ± 7.14; P = 0.106. Diagnosis between the two lobes showed substantial (κ = 0.830) concordance. Left-lobe (κ value 0.878) and right-lobe (κ = 0.903) biopsies showed no difference when compared with bi-lobar biopsies. Adverse events were observed in two patients, both of whom had biopsies of the right lobe.

Conclusions EUS-guided left-lobe liver biopsy is safer than right-lobe biopsy with similar diagnostic yield.



Publication History

Received: 24 June 2022

Accepted after revision: 28 October 2022

Accepted Manuscript online:
14 November 2022

Article published online:
23 February 2023

© 2022. 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 commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
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Comment to this article:

Endoscopy International Open – recently publishedEndoscopy 2023; 55(05): 487-487
DOI: 10.1055/a-2017-8135

 

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