Comparison of EUS-guided versus percutaneous and transjugular approaches for the performance of liver biopsies

Dig Liver Dis. 2019 Jun;51(6):826-830. doi: 10.1016/j.dld.2019.01.006. Epub 2019 Jan 22.

Abstract

Background: Liver biopsy through endoscopic ultrasound (EUS) has become a novel approach for tissue acquisition. We aim to evaluate the adequacy of EUS-guided liver biopsies in comparison to those obtained through interventional radiology (IR) techniques.

Methods: A retrospective single-center analysis was performed of all IR (transjugular or image-guided percutaneous) and EUS-guided liver biopsies performed at an academic medical center from January 2016 to January 2018. Patient demographics, histologic characteristics, and clinical outcomes were collected.

Results: 152 procedures were included for analysis. 45% of liver biopsies were performed through EUS-guidance. The most common indication for liver biopsy was NASH fibrosis staging (n = 64). IR-guided biopsies contained a higher number of complete portal triads (13.6 vs. 10.8 p ≤ 0.01) while EUS-guided biopsies produced an increased total specimen length (4.6 cm vs. 3.6 cm p ≤ 0.01).47% of biopsy samples were fragmented with the majority of these (72%) occurring with EUS-guided procedures (p ≤ 0.01). IR-guided biopsies led to more complications in comparison to EUS-guided procedures (p = 0.03) CONCLUSION: Liver biopsies performed through EUS-guidance are comparable to IR-guided liver biopsies and may have an enhanced safety profile with acceptable tissue acquisition characteristics. Standardization of techniques and needles is needed for optimization of tissue sampling.

Keywords: Complications; Liver biopsy; Tissue adequacy.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Endoscopic Ultrasound-Guided Fine Needle Aspiration / instrumentation*
  • Endosonography*
  • Female
  • Humans
  • Image-Guided Biopsy / instrumentation
  • Image-Guided Biopsy / methods*
  • Liver / pathology*
  • Male
  • Middle Aged
  • Needles
  • Retrospective Studies