Endoscopic ultrasound-guided liver biopsy: a multicenter experience Editorial Material

Open Access

cited authors

  • Diehl, David L., Johal, Amitpal S., Khara, Harshit S., Stavropoulos, Stavros N., Al-Haddad, Mohammed, Ramesh, Jayapal, Varadarajulu, Shyam, Aslanian, Harry, Gordon, Stuart R., Shieh, Frederick K., Pineda-Bonilla, Jonh J., Dunkelberger, Theresa, Gondim, Dibson D., Chen, Eric Z.

abstract

  • Background and aims: Endoscopic ultrasound-guided (EUS) liver biopsy (LB) is proposed as a newer method that offers several advantages over existing techniques for sampling liver tissue. This study evaluated the diagnostic yield of EUS-LB as the primary outcome measure. In addition, the safety of the technique in a large patient cohort was assessed. Patients and methods: Patients undergoing EUS for evaluation of elevated liver enzymes or hepatic diseasewere included in this prospective, non-randomized, multicenter study. EUS-LB was performed with EUS-fine needle aspiration (FNA; 19-gauge needle). Tissue was formalin-fixed and stained with hematoxylin and eosin, and trichrome. Using a microscope micrometer, specimen length was measured and the number of complete portal triads (CPTs) were counted. The main outcome measure was to assess the diag-nostic yield of EUS-LB, and to monitor for any procedure-related complications. Results: Patients (110; median age, 53 years; 62 women) underwent EUS-LB at eight centers. The indication was abnormal liver enzymes in 96 patients. LB specimens sufficient for pathological diagnosis were obtained in 108 of 110 patients (98 %). The overall tissue yield from 110 patients was a median aggregate length of 38mm (range, 0-203), with median of 14 CPTs (range, 0-68). There was no statistical difference in the yield between bilobar, left lobe only, or right lobe only biopsies. There was one complication (0.9 %) where self-limited bleeding occurred in a coagulopathic and thrombocytopenic patient. This complication was managed conservatively. Conclusions: EUS-guided LB was a safe technique that yields tissue adequate for diagnosis among 98% of patients evaluated.

authors

Publication Date

  • June 1, 2015

webpage

published in

category

start page

  • E210

end page

  • E215

volume

  • 3

issue

  • 3

WoS Citations

  • 21

WoS References

  • 11