Efficacy and safety of EUS-guided liver biopsy: a systematic review and meta-analysis

Mohan, Babu P.; Shakhatreh, Mohammed; Garg, Rajat; Ponnada, Suresh; Adler, Douglas G.

doi:10.1016/j.gie.2018.10.018

Cited by 126 publications

(110 citation statements)

References 26 publications

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“…In a recent meta-analysis published by Mohan et al, 437 patients who had undergone EUS-LB were studied [4]. The yield was 93.9 % and the AE rate was 2.3 %, proving the safety and efficacy of EUS-LB.…”

Section: Discussionmentioning

confidence: 98%

“…The Acquire needle's design consisting of the three-point heel allows maximum tissue capture and minimal fragmentation. On the other hand, the Sharkcore needle design consists of six distal cutting edges, which facilitates obtaining cohesive units of tissue with preserved cell architecture [4].…”

Section: Discussionmentioning

confidence: 99%

“…Endoscopic ultrasound-guided liver biopsy (EUS-LB) is an emerging procedure that offers an alternative to conventional percutaneous and transjugular liver biopsy approaches [4,5]. EUS-guided liver biopsy has been shown to be efficacious in diagnosing both malignant and parenchymal liver disease.…”

mentioning

confidence: 99%

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EUS-guided fine-needle core liver biopsy with a modified one-pass, one-actuation wet suction technique comparing two types of EUS core needles

et al. 2020

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Background and study aims We compared the diagnostic yield and specimen adequacy in EUS-guided parenchymal biopsies between two types of EUS 19 G core needles. Patients and methods This is a retrospective study of 420 patients at two tertiary medical centers in Florida with unexplained abnormal liver associated tests were referred for EUS evaluation of biliary obstruction and pancreatic pathology. EUS-guided liver biopsy (EUS-LB) was performed at the same session after biliary obstruction was excluded. We compared intact specimen length (ISL), total specimen length (TSL), complete portal triads (CPT) and adverse events (AE). Welch’s T and Tukey tests were used for ISL, TSL and CPT. Results A total of 210 patients underwent EUS-LB using a Franseen needle, 210 patients using a fork-tip needle. Median patient age was 52 years (15.63) and 238 (56.7 %) were female. The fork-tip needle had a mean ISL of 2.7 (1.1 SD) cm, TSL of 6 cm (2.1 SD), and mean 19.5 CPT (8.5 SD) Abdominal pain occurred in 35 patients (17 %) post-procedure and was managed with supportive care. Two patients required intravenous (IV) narcotic administration. Subcapsular hematomas occurred in 1 (0.5 %) patients. The Franseen needle had a mean ISL of 3.1 cm (1.3 SD), TSL of 6.5 cm (2.6 SD), and mean of 24 CPT (8.8 SD). Abdominal pain occurred in four patients (2 %) post-procedure, which resolved in all patients after IV narcotic administration. Subcapsular hematomas occurred in 1 (0.5 %) and bile leak in 1(0.4 %) patients. Conclusions Use of the Franseen needle resulted in better liver core samples than that obtained with a fork-tip needle.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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EUS-guided fine-needle core liver biopsy with a modified one-pass, one-actuation wet suction technique comparing two types of EUS core needles

et al. 2020

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“…12,16,17 In a recently published meta-analysis including 9 studies (437 patients) the pooled rate of histological diagnosis was 93.9% (95% confidence interval [CI] = 84.9-97.7, heterogeneity [I 2 ] = 75.3%). 18 Despite the high yield the rates of adverse events remain low. In the same meta-analysis, pooled overall adverse event rates were 2.3% (95% CI = 1.1-4.8, I 2 = 0) and the risk of bleeding was 1.2% (95% CI = 0.4-3.7, I 2 = 0).…”

mentioning

confidence: 99%

“…In the same meta-analysis, pooled overall adverse event rates were 2.3% (95% CI = 1.1-4.8, I 2 = 0) and the risk of bleeding was 1.2% (95% CI = 0.4-3.7, I 2 = 0). 18 Despite the advantages and proven efficacy and safety, EUS-LB remains underutilized due to concerns regarding adequacy of tissue obtained, the problem of tissue fragmentation, cost of needles/anesthesia, and fear of bleeding.…”

mentioning

confidence: 99%