Endoscopic ultrasound and the liver: current applications and beyond

Shah, Neil; Baron, Todd H.

doi:10.1002/jhbp.528

Cited by 7 publications

(4 citation statements)

References 99 publications

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“…With increasing experience in the use of EUS in the liver, several series have reported its use in performing both non-targeted and targeted liver biopsies, with diagnostic yield of 90-100% and a low complication rate, even when using 19 G needles. [102][103][104] One recent retrospective, non-randomised, single-centre study 105 of 90 patients found that the biopsy specimens obtained by the percutaneous route, compared with the EUS route, gave significantly more portal tracts (13 vs 5) and were more likely to enable a histological diagnosis (100% vs 93%), although those patients in the ultrasound group had a significantly shorter hospital stay (median hospital stay 3 vs 4.2 hours) and reported less pain (median pain score 0 vs 3.5). A tip-core biopsy needle delivers bigger samples than fine-needle aspiration biopsy needles.…”

Section: Endoscopic Ultrasound (Eus) Guided Liver Biopsymentioning

confidence: 99%

Guidelines on the use of liver biopsy in clinical practice from the British Society of Gastroenterology, the Royal College of Radiologists and the Royal College of Pathology

Neuberger

Patel

Caldwell

et al. 2020

Gut

253

201

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Liver biopsy is required when clinically important information about the diagnosis, prognosis or management of a patient cannot be obtained by safer means, or for research purposes. There are several approaches to liver biopsy but predominantly percutaneous or transvenous approaches are used. A wide choice of needles is available and the approach and type of needle used will depend on the clinical state of the patient and local expertise but, for non-lesional biopsies, a 16-gauge needle is recommended. Many patients with liver disease will have abnormal laboratory coagulation tests or receive anticoagulation or antiplatelet medication. A greater understanding of the changes in haemostasis in liver disease allows for a more rational, evidence-based approach to peri-biopsy management. Overall, liver biopsy is safe but there is a small morbidity and a very small mortality so patients must be fully counselled. The specimen must be of sufficient size for histopathological interpretation. Communication with the histopathologist, with access to relevant clinical information and the results of other investigations, is essential for the generation of a clinically useful report.

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Section: Endoscopic Ultrasound (Eus) Guided Liver Biopsymentioning

confidence: 99%

Guidelines on the use of liver biopsy in clinical practice from the British Society of Gastroenterology, the Royal College of Radiologists and the Royal College of Pathology

Neuberger

Patel

Caldwell

et al. 2020

Gut

253

201

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“…Still, there are a limited number of papers that analyze the feasibility and safety of EUS guided FNA for focal liver lesions. EUS and FNA of liver lesions is considered a "rescue" diagnosis method, after an unsuccessful or impossible approach by classical biopsy guiding methods [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Accuracy of endoscopic ultrasound-guided biopsy of focal liver lesions

et al. 2020

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Aim: Endoscopic ultrasound (EUS) has become an indispensable method for diagnosis in gastroenterology and new indications for EUS continue to emerge. However, there are limited data regarding the accuracy of EUS-guided biopsy of hepatic focal lesions. The aim of this study was to assess the diagnostic yield of EUS-guided fine needle aspiration (FNA) of focal liver lesions.Material and methods: We conducted a prospective study in which patients with focal liver lesions, detected by transabdominal ultrasound and computed tomography or magnetic resonance imaging, underwent EUS-guided FNA to determine the diagnostic yield of the procedure.Results: In 47/48 of patients, the results of EUS-FNA were positive for malignancy, while in one case the acquired fragment was insufficient for appropriate histological analysis. Diagnostic yield was 0.98. In 83% of the cases biopsies were taken from the left lobe and in 17% from the right lobe with the same technical success rate. The most common diagnosis was metastatic adenocarcinoma of the pancreas (26% cases) followed by cholangiocarcinoma (17% cases). Concurrent sampling of other sites in addition to the liver and/or primary tumor was realized in 35% of the cases, with results that correlated with the liver biopsy and with the primary tumor biopsy. We reported no immediate or long-term complications in any of the patients.Conclusions: EUS guided fine needle aspiration/biopsy of focal liver lesions is safe, provides a very high diagnostic accuracy and should not be considered only as a rescue method after failure of percutaneous guided biopsies.

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“…La USE permite detectar tempranamente los cambios de la circulación colateral en los pacientes con hipertensión portal. La USE permite no solo evaluar el drenaje intrínseco del esófago que se presenta como várices visibles en la endoscopia tradicional, sino también la identificación de venas extrínsecas a lo largo de la unión gastroesofágica, incluidas las várices periesofágicas y las paraesofágicas (30). Entonces, este método permite la visualización de várices esofágicas, gástricas, colaterales venosas, el sistema portal, la vena ácigos y el conducto torácico (31,32).…”

Section: Ultrasonografía Endoscópica (Use)unclassified

Métodos diagnósticos en hipertensión portal

Maya

Ferrusquía‐Acosta

Serna-Patiño

et al. 2021

Rev colomb Gastroenterol

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La hipertensión portal es un síndrome caracterizado por el incremento en el gradiente de presión portal, definido por la diferencia entre la presión de la porta y la vena cava inferior. Esta presión depende del flujo venoso y la resistencia vascular. En los pacientes cirróticos estas dos variables están alteradas de manera suprafisiológica, inicialmente por la lesión estructural dependiente de fibrosis y los nódulos de regeneración y posteriormente por cambios dinámicos vasculares que causan vasoconstricción intrahepática y vasodilatación esplácnica, lo cual explica las manifestaciones sistémicas de la cirrosis. La importancia de la hipertensión portal radica en la frecuencia y severidad de las complicaciones asociadas, especialmente la hemorragia variceal y otras como ascitis, peritonitis bacteriana espontanea, síndrome hepatorrenal y encefalopatía hepática. El objetivo de este artículo es realizar una revisión actualizada sobre el uso de las pruebas diagnósticas invasivas y no invasivas disponibles para el estudio de la hipertensión portal y su aplicación en la práctica clínica.

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Endoscopic ultrasound and the liver: current applications and beyond

Cited by 7 publications

References 99 publications

Guidelines on the use of liver biopsy in clinical practice from the British Society of Gastroenterology, the Royal College of Radiologists and the Royal College of Pathology

Guidelines on the use of liver biopsy in clinical practice from the British Society of Gastroenterology, the Royal College of Radiologists and the Royal College of Pathology

Accuracy of endoscopic ultrasound-guided biopsy of focal liver lesions

Métodos diagnósticos en hipertensión portal

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