The Role of EUS in Liver Biopsy
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Purpose of Review
EUS-guided liver biopsy (EUS-LB) is being used with increased frequency to perform parenchymal liver biopsy. Evolution of the technique can now achieve excellent liver tissue cores. This review covers important developments in this procedure.
Clinical studies have recently demonstrated that the 19G EUS core biopsy needle is superior to non-core needles for liver tissue acquisition. In addition, wet suction provides more robust tissue samples than dry suction. Heparin priming of the needle (instead of saline) can prevent blood clogging within the needle lumen. A 1-hour recovery time after the EUS-LB is sufficient in almost all cases. The EUS-LB can deliver bilobar biopsies, which can decrease sampling error. Patients who need a liver biopsy in addition to an endoscopy or EUS are best served by the EUS-LB, as the combination procedure saves time and cost.
The EUS-LB is a safe and effective means for procuring good liver core biopsies. Incremental improvements in technique have increased quality of the resulting specimen. Future directions of this technique are discussed.
KeywordsLiver biopsy Endoscopic ultrasound Fine needle biopsy Non-alcoholic steatohepatitis
Endoscopic ultrasound–guided liver biopsy
Fine needle aspiration
Fine needle biopsy
Non-alcoholic fatty liver disease
Compliance with Ethical Standards
Conflict of Interest
David Diehl reports working as a consultant for Boston Scientific, Medtronic, Olympus America, and Cook Medical. Shaffer Mok reports working as a consultant for Medtronic and grants from Pentax/C2 Therapeutics, outside the submitted work.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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