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CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(11): E1309-E1314
DOI: 10.1055/a-2427-2427
Original article

Endoscopic ultrasound-guided tissue acquisition for focal liver lesions can be safely performed in patients with ascites

Yuichi Takano 
1   Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan (Ringgold ID: RIN26858)
,
Naoki Tamai
1   Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan (Ringgold ID: RIN26858)
,
Masataka Yamawaki
2   Showa Daigaku Fujigaoka Byoin, Yokohama, Japan (Ringgold ID: RIN26858)
,
Jun Noda
1   Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan (Ringgold ID: RIN26858)
,
Tetsushi Azami
1   Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan (Ringgold ID: RIN26858)
,
Fumitaka Niiya 
3   Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan (Ringgold ID: RIN26858)
,
Fumiya Nishimoto
1   Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan (Ringgold ID: RIN26858)
,
Naotaka Maruoka
1   Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan (Ringgold ID: RIN26858)
,
Tatsuya Yamagami
2   Showa Daigaku Fujigaoka Byoin, Yokohama, Japan (Ringgold ID: RIN26858)
,
Masatsugu Nagahama
1   Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan (Ringgold ID: RIN26858)
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Abstract

Background and study aims In patients with ascites, percutaneous liver biopsy is generally contraindicated. Because endoscopic ultrasound-guided tissue acquisition (EUS-TA) allows tissue sample obtention from the digestive tract lumen, a biopsy without the intervention of ascites may prevent adverse events (AEs). This study aimed to evaluate the safety of EUS-TA for focal liver lesions in the presence of ascites.

Patients and methods A retrospective study was conducted using medical records of cases in which EUS-TA was performed on focal liver lesions between 2016 and 2022. Study participants were classified into two groups: those with ascites and those without it, and the outcomes were compared. The primary outcome was AEs.

Results We included 109 cases of EUS-TA for focal liver lesions. Ascites was present in 20.1% of cases (22/109) and absent in 79.8% of cases (87/109). There were no significant differences between the two groups in clinical backgrounds and EUS-TA procedure, although fine-needle biopsy needles were significantly more frequently used in patients without ascites. In the ascites group, puncture without intervening ascites was successful in 90.9% of cases (20/22). The incidence of AEs was 4.5% (1/22) in the ascites group and 1.1% (1/87) in the non-ascites group, showing no significant difference. The two AEs were mild self-limiting abdominal pain.

Conclusions In focal liver lesions with ascites, EUS-TA allows biopsy without the intervention of ascites in most cases. The incidence of AEs did not differ significantly between patients with and without ascites.

Keywords

Endoscopic ultrasonography - Tissue diagnosis - Fine-needle aspiration/biopsy - Biliary tract - Intervention EUS


Publication History

Received: 09 August 2024

Accepted after revision: 23 September 2024

Accepted Manuscript online:
30 September 2024

Article published online:
18 November 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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