ENDOSCOPIC ULTRASOUND-GUIDED LIVER BIOPSY: A SAFE AND EFFECTIVE CHOICE IN THE STUDY OF HEPATIC DISEASES

Aims Percutaneous liver biopsy has been considered as the main technique for liver diseases anatomopathological diagnosis. Endoscopic ultrasound-guided liver biopsy (EUS-LB) has been reported as an alternative. The aim is to evaluate the diagnostic yield, related factors and the safety of the EUS-LB.

Methods Descriptive analysis from an unicenter prospective database of patients who underwent EUS-LB from 12/2019 to 10/2021. We defined diagnostic yield as a satisfactory sample, which provided a successful histopathological diagnosis.

Results Sixty-two procedures (59 patients) were identified, over a total of 1807 EUS carried out in mentioned period (age: 56±14.2 years; 66.1% women). 19G-aspiration needle(FNA) was used in 6.5% of the procedures and 22G and 19G-core biopsy needle(FNB) in 22.6% and 71%, respectively. Global diagnostic yield was of 90.3%. Median number of portal tracts(NPT) were 9(95%CI:6.3-13.3) and median specimen length was 13.5mm(95%CI:10-15). The needle type and the NPT obtained were the only factors related to diagnostic yield, which was 25% for 19G-FNA needle, and 78% and 100% for 22G and 19G-FNB needles (p<0.0005). Median NPT in diagnostic samples were 10(95%IC:7.7-14) versus 1(95%CI:0-4.6) in non-diagnostic samples (p=0.0002). NPT was 14(95%CI:9-16) for 19G-FNB needles versus 4(95%IC:3.6) with other needles (p<0.0001). Only 3.2% of mild adverse effects was observed (post-puncture gastric-wall bleeding treated with clip and a preventive hospitalization for suspected hepatic bleeding that was later not confirmed).

Conclusions EUS-LB is a safe and effective procedure. We recommend the use of 19G-FNB needles to obtain a higher diagnostic yield given that it is related with a greater NPT acquired.

Publication History

Article published online:
14 April 2022