Endosc Int Open 2015; 3(03): E210-E215
DOI: 10.1055/s-0034-1391412
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic ultrasound-guided liver biopsy: a multicenter experience

David L. Diehl
1   Geisinger Medical Center, Department of Gastroenterology and Nutrition, Danville, Pennsylvania, United States
,
Amitpal S. Johal
1   Geisinger Medical Center, Department of Gastroenterology and Nutrition, Danville, Pennsylvania, United States
,
Harshit S. Khara
1   Geisinger Medical Center, Department of Gastroenterology and Nutrition, Danville, Pennsylvania, United States
,
Stavros N. Stavropoulos
2   Winthrop University Hospital, Departments of Gastroenterology, Hepatology and Nutrition, Mineola, New York, United States
,
Mohammed Al-Haddad
3   Indiana University, Department of Gastroenterology and Hepatology, Indianapolis, Indiana, United States
,
Jayapal Ramesh
4   University of Alabama at Birmingham, Division of Gastroenterology and Hepatology, Birmingham, Alabama, United States
,
Shyam Varadarajulu
5   Florida Hospital, Center for Interventional Endoscopy, Orlando, Florida, United States
,
Harry Aslanian
6   Yale University School of Medicine, Department of Medicine, Section of Digestive Diseases, New Haven, Connecticut, United States
,
Stuart R. Gordon
7   Dartmouth-Hitchcock Medical Center, Department of Gastroenterology, Lebanon, New Hampshire, United States
,
Frederick K. Shieh
1   Geisinger Medical Center, Department of Gastroenterology and Nutrition, Danville, Pennsylvania, United States
,
Jonh J. Pineda-Bonilla
1   Geisinger Medical Center, Department of Gastroenterology and Nutrition, Danville, Pennsylvania, United States
,
Theresa Dunkelberger
1   Geisinger Medical Center, Department of Gastroenterology and Nutrition, Danville, Pennsylvania, United States
,
Dibson D. Gondim
8   Indiana University, Department of Pathology and Laboratory Medicine, Indianapolis, Indiana, United States
,
Eric Z. Chen
1   Geisinger Medical Center, Department of Gastroenterology and Nutrition, Danville, Pennsylvania, United States
› Author Affiliations
Further Information

Publication History

submitted 05 December 2014

accepted after revision 24 December 2014

Publication Date:
27 February 2015 (online)

Background and aims: Endoscopic ultrasound-guided (EUS) liver biopsy (LB) is proposed as a newer method that offers several advantages over existing techniques for sampling liver tissue. This study evaluated the diagnostic yield of EUS-LB as the primary outcome measure. In addition, the safety of the technique in a large patient cohort was assessed.

Patients and methods: Patients undergoing EUS for evaluation of elevated liver enzymes or hepatic disease were included in this prospective, non-randomized, multicenter study. EUS-LB was performed with EUS-fine needle aspiration (FNA; 19-gauge needle). Tissue was formalin-fixed and stained with hematoxylin and eosin, and trichrome. Using a microscope micrometer, specimen length was measured and the number of complete portal triads (CPTs) were counted. The main outcome measure was to assess the diagnostic yield of EUS-LB, and to monitor for any procedure-related complications.

Results: Patients (110; median age, 53 years; 62 women) underwent EUS-LB at eight centers. The indication was abnormal liver enzymes in 96 patients. LB specimens sufficient for pathological diagnosis were obtained in 108 of 110 patients (98 %). The overall tissue yield from 110 patients was a median aggregate length of 38 mm (range, 0 – 203), with median of 14 CPTs (range, 0 – 68). There was no statistical difference in the yield between bilobar, left lobe only, or right lobe only biopsies. There was one complication (0.9 %) where self-limited bleeding occurred in a coagulopathic and thrombocytopenic patient. This complication was managed conservatively.

Conclusions: EUS-guided LB was a safe technique that yields tissue adequate for diagnosis among 98 % of patients evaluated.

 
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