Endoscopic ultrasound-guided liver biopsy in pediatric patients

Johal, Amitpal S.; Khara, Harshit S.; Maksimak, Martin; Diehl, David L.

doi:10.4103/2303-9027.138794

Cited by 18 publications

(7 citation statements)

References 8 publications

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“…EUS in pediatrics continues to evolve, following the path of EUS in the adult patient population. Similarly in adult patients, endosonographers are performing EUS-guided liver biopsy, varix therapy, and EUS-guided biliary access in children ( 60 ). As techniques become more common for adult patients, we can expect these procedures to be used and studied in pediatric patients.…”

Section: Discussionmentioning

confidence: 99%

EUS in Pediatrics: A Multicenter Experience and Review

Piester

Liu

2021

Front. Pediatr.

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Background/Aim: Endoscopic ultrasound (EUS) is a well-established tool used in the evaluation and treatment of a wide range of pathologies in adult medicine. EUS in pediatrics has been shown to be safe and technically effective, and its use continues to evolve. This article aims to describe the EUS experience at our tertiary-care centers with regard to safety, technical success, and its impact in clinical management. We also discuss the current and developing diagnostic and therapeutic uses for EUS in pediatrics such as in pancreaticobiliary disease, congenital anomalies, eosinophilic esophagitis, inflammatory bowel disease, and liver disease.Methods: This is a retrospective review of EUS performed by two pediatric gastroenterologists trained as endosonographers between April 2017 and November 2020. Patient demographics, procedure indication, procedure characteristics, technical success, and complications were collected. Literature review was performed to describe current and future uses of EUS in pediatrics.Results: Ninety-eight EUS were performed with 15 (15.3%) including fine needle aspiration/biopsy and 9 (9.2%) cases being therapeutic. Most common indications include choledocholithiasis (n = 31, 31.6%), pancreatic fluid collections (n = 18, 18.4%), chronic and acute recurrent pancreatitis (n = 14, 14.3%), and acute pancreatitis characterization (n = 13, 13.3%). Notable indications of pancreatic mass (n = 6, 6.1%) and luminal lesions/strictures (n = 6, 6.1%) were less common. Complications were limited with one instance of questionable GI bleeding after cystgastrostomy creation. Ninety-eight of 98 (100%) cases were technically successful.Conclusion/Discussion: EUS has been shown to be performed safely and successfully in the pediatric population by pediatric endosonographers. This study and review support its use in pediatric practice and demonstrate the wide variety of indications for EUS such as pancreatic cystgastrostomy, celiac plexus neurolysis, and evaluation of chronic pancreatitis. This literature review also demonstrates areas of potential development for EUS within the practice of pediatric gastroenterology.

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Section: Discussionmentioning

confidence: 99%

EUS in Pediatrics: A Multicenter Experience and Review

Piester

Liu

2021

Front. Pediatr.

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“…Indications of a diagnostic EUS in children include evaluation of idiopathic recurrent pancreatitis, tissue sampling or pancreatic cyst aspiration for analysis, suspected choledocholithiasis, submucosal lesions (esophageal, gastric, rectal), and congenital disorders (esophageal stenosis, tracheobronchial remnants, duodenal duplication cysts) [ 27 - 29 ]. EUS has also been used for assessing portal hypertension and performing a liver biopsy when required [ 30 ].…”

Section: Endoscopic Ultrasonography In Childrenmentioning

confidence: 99%

Advanced Therapeutic Gastrointestinal Endoscopy in Children – Today and Tomorrow

Nabi

Reddy

2018

Clin Endosc

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This Executive summary of the Guideline on pediatric gastrointestinal endoscopy from the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) refers to infants, children, and adolescents aged 0 -18 years. The areas covered include: indications for diagnostic and therapeutic esophagogastroduodenoscopy and ileocolonoscopy; endoscopy for foreign body ingestion; endoscopic management of corrosive ingestion and stricture/stenosis; upper and lower gastrointestinal bleeding; endoscopic retrograde cholangiopancreatography, and endoscopic ultrasonography.

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“…13 Since EUS-LB is performed under sedation, it can be done with ease in pediatric population. 14 Furthermore, the procedure can be done in the same sitting when performing a diagnostic EUS for evaluation of jaundice or liver pathology.…”

Section: Introductionmentioning

confidence: 99%

EUS-Guided versus Percutaneous Image-Guided Liver Biopsy: A Battle for Supremacy!

Mishra

Bush

Rana

2021

Journal of Digestive Endoscopy

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Liver biopsy has been the gold standard investigation for diagnosing and staging liver diseases. Image-guided percutaneous liver biopsy is a time-tested technique for obtaining the liver tissue in diffuse liver diseases. However, it is contraindicated in patients with ascites, altered mental status, skin infections, coagulopathy, and thrombocytopenia. It is associated with adverse events including postprocedure pain, bleeding, and pneumothorax. Transvenous liver biopsy can be performed in most cases with these contraindications, but it is an expensive technique and has its own inherent risks. Endoscopic ultrasound (EUS)-guided liver biopsy (EUS-LB) is a relatively new technique that has shown promising results and seems to have a potential of replacing percutaneous liver biopsy. In this news and views, we discuss the results of a randomized controlled trial (RCT) comparing EUS-guided and percutaneous techniques of liver biopsy. This RCT reported that percutaneous technique is superior in terms of diagnostic adequacy and total expenditure without any significant adverse effects compared with EUS-LB. EUS-LB is a promising technique that needs to be further explored in terms of appropriate situations in which it can be preferred over percutaneous or transvenous routes.

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Endoscopic ultrasound-guided liver biopsy in pediatric patients

Cited by 18 publications

References 8 publications

EUS in Pediatrics: A Multicenter Experience and Review

EUS in Pediatrics: A Multicenter Experience and Review

Advanced Therapeutic Gastrointestinal Endoscopy in Children – Today and Tomorrow

EUS-Guided versus Percutaneous Image-Guided Liver Biopsy: A Battle for Supremacy!

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