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The efficacy and safety of endoscopic ultrasound-guided liver biopsy versus percutaneous liver biopsy in patients with chronic liver disease: a retrospective single-center study

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Abstract

Background and aims

There is limited literature on endoscopic ultrasound-guided liver biopsy (EUS-LB), a new method of obtaining liver biopsy (LB).

Methods

We conducted a retrospective study of the efficacy and safety of EUS-LB compared to percutaneous liver biopsy (PC-LB) in patients with chronic liver disease at our center between January 2018 and August 2019.

Results

Thirty patients underwent EUS-LB and 60 patients underwent PC-LB were identified (median follow-up post-LB was 8 days; interquartile range (IQR), 3–5 days). The median number of portal tracts was significantly higher in the PC-LB group (13 vs. 5; P < 0.0001). A histologic diagnosis was established in 93% of the EUS-LB group, compared to 100% in the PC-LB group (P = 0.841). Patients in EUS-LB group had significantly shorter hospital stay (median time of hospital stay was 3 vs. 4.2 h in the EUS-LB vs. PC-LB group, respectively; P = 0.004) and reported less pain compared to PC-LB group (median pain score was 0 vs. 3.5; P = 0.0009). EUS-LB were performed using a 19-gauge (n = 27) or 22-gauge (n = 3); there was a tendency towards higher number of portal tracts in the 22- vs. the 19-gauge needle group (6 vs. 5; P = 0.501). No patient in either group had significant adverse events such as bleeding or death.

Conclusion

EUS-LB is safe and is associated with less pain, shorter hospital stay, and high diagnostic yield (93%) compared to PC-LB. Randomized trials are needed to standardize the utility of EUS-LB.

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Abbreviations

CHC:

Chronic hepatitis C

CRN:

Clinical Research Network

EH:

Eosinophilic hepatitis

ESLD:

End-stage liver disease

EUS-LB:

Endoscopic ultrasound-guided liver biopsy

EUS-FNA/FNB:

Endoscopic ultrasound-guided fine needle aspiration or biopsy

FLD:

Fatty liver disease

IRB:

Institutional Review Board

LB:

Liver biopsy

NAFLD:

Non-alcoholic fatty liver disease

NASH:

Non-alcoholic steatohepatitis

NAS:

NAFLD activity score

PBC:

Primary biliary cholangitis

PC-LB:

Percutaneous-guided liver biopsy

PFIC:

Progressive familial intrahepatic cholestasis

VCTE:

Vibration-controlled transient elastography

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, University of Missouri-School of Medicine, One Hospital Drive, Columbia, MO, 65212, USA

    Ahmad Hassan Ali, Sarjukumar Panchal, Alhareth Al-Juboori, Sami Samiullah, Jamal A. Ibdah & Ghassan M. Hammoud

  2. Department of Pathology and Anatomical Sciences, University of Missouri-School of Medicine, Columbia, MO, USA

    Deepthi S. Rao & Yujun Gan

Authors
  1. Ahmad Hassan Ali
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  2. Sarjukumar Panchal
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  3. Deepthi S. Rao
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  5. Alhareth Al-Juboori
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Contributions

GMH, AHA, and SP contributed to the concept, design, literature search, clinical studies, data acquisition, statistical analysis, manuscript preparation, manuscript editing, and manuscript review. DSR and YG re-examined the liver biopsies. AA, SS, and JAI reviewed and edited the manuscript.

Corresponding author

Correspondence to Ghassan M. Hammoud.

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The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

This is a retrospective study that involved only chart review. No animals were involved in any aspect of this study.

Informed consent

Obtaining informed consent has been waived by the institution’s IRB due to nature of the study (retrospective and chart review study).

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Ali, A.H., Panchal, S., Rao, D.S. et al. The efficacy and safety of endoscopic ultrasound-guided liver biopsy versus percutaneous liver biopsy in patients with chronic liver disease: a retrospective single-center study. J Ultrasound 23, 157–167 (2020). https://doi.org/10.1007/s40477-020-00436-z

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