Patient-reported experience measures of EUS-guided and percutaneous liver biopsy. a prospective observational study

Introduction: Liver biopsy is a critical procedure for diagnosing and/or staging of liver diseases. Percutaneous liver biopsy (PC-LB) is the golden standard. Endoscopic ultrasound-guided liver biopsy (EUS-LB) has emerged as a promising alternative. While clinical efficacy and safety are well documented, less is known about the patient-reported experience measures (PREMs) associated with this approach.

Aims: This study aims to compare PREMs between EUS-LB and PC-LB.

Methods: This is a prospective observational study. Within the study period from September 2023 to September 2024, we included all consecutive non-targeted EUS-LB and PC-LB at our tertiary liver centre. To avoid selection bias from April 2024 on all biopsies were switched from exclusively PC-LB to exclusively EUS-LB. A modified questionnaire based on the validated Newcastle ENDOPREM was used. The questionnaire comprises multiple domains (demographics, expectations, pain quality and quantity, discomfort, well-being, satisfaction). Clinical data were retrieved from electronic patient charts.

Results: This study included 102 patients, of whom 58 underwent EUS-LB and 44 PC-LB. Median age was 53 years (40-61), 49% of the patients were male. Indications were routine biopsy after liver transplantation (37.3%), abnormal liver function tests (34.3%), guidance of therapy in autoimmune liver disease (28.4%). Technical success was 100%. There was no statistically significant difference in postinterventional complications (3.4% in EUS-LB vs. 0% in PC-LB; p=0.51).

Patients in the EUS-LB group experienced significantly less pain and discomfort of the procedure (p<0.05) and reported significantly less pain overall during the examination (p<0.05) compared to PC-LB. Duration and intensity of pain was significantly shorter and lower in EUS-LB compared to PC-LB (p<0.05). Discomfort was significantly lower in EUS-LB (p<0.05), while no significant differences were observed in the other domains of the questionnaire.

Conclusions: Pain severity, duration and overall discomfort was significantly reduced in EUS-LB compared to PC-LB. The results support the use of EUS-LB as a patient-preferred method for untargeted liver biopsy, which could enhance patient compliance and satisfaction.

Präsentiert in der Sitzung: Endoskopie trifft Hepatologie – Potenzial der Endohepatologie

Freitag, 19. September 2025, 17:00 – 18:30, Saal 2