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CC BY 4.0 · Journal of Digestive Endoscopy 2024; 15(02): 110-115
DOI: 10.1055/s-0044-1785498
Research Article

Endoscopic Ultrasound-Guided Liver Biopsy (EUS-LB): An Endoscopic Solution to the Unmet Needs of Liver Tissue Acquisition and Beyond

Shivam Khare
1   Department of Medical Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India
,
Anil Arora
2   Department of Medical Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India
,
Jijo Varghese 
3   Department of Gastroenterology, N S Hospital Kollam, Thazhuthala, Kerala, India
,
Ashish Kumar
2   Department of Medical Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India
,
Sunila Jain
4   Department of Pathology, Sir Ganga Ram Hospital, New Delhi, India
,
Ashiesh Khandelwal
2   Department of Medical Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India
,
Arpita Mittal
5   Department of Pathology, Sir Ganga Ram Hospital, New Delhi, India
,
Sunayana Misra
6   Department of Pathology, Sir Ganga Ram Hospital, New Delhi, India
,
Shrihari Anikhindi 
1   Department of Medical Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India
,
Mandhir Kumar
2   Department of Medical Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India
,
Piyush Ranjan
2   Department of Medical Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India
,
Praveen Sharma
2   Department of Medical Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India
,
Naresh Bansal
2   Department of Medical Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India
,
Munish Sachdeva
2   Department of Medical Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India
,
Suprabhat Giri 
7   Kalinga Institute of Medical Sciences, Bhubaneswar, Orissa, India
,
Srijaya S.
8   Department of Medical Gastroenterology, Medical College Trivandrum, Thiruvananthapuram, Kerala, India
› Author Affiliations Funding None.
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Abstract

Aim and Objective Endoscopic ultrasound-guided liver biopsy (EUS-LB) is now increasingly being used across the globe as a method of liver tissue acquisition. This method is widely accepted by many professionals as it can overcome many shortcomings of percutaneous liver biopsy and transjugular liver biopsy. The aim of the study is to obtain the adequate and optimal biopsy rate associated with EUS-LB.

Materials and Methods This is a retrospective observational study. Consecutive patients undergoing EUS-LB during the study period who were willing to consent were taken up for the study.

Results Total 91 patients were taken up for the study. Median age of study population was 44 years out of which 39 patients were males and 52 were females (42.9 and 57.1%). Adequate biopsy rate (according to European Association for the Study of Liver Disease criteria) and optimal biopsy rate (according to American Association for the Study of Liver Diseases criteria) were 89 (81/91) and 60.4% (55/91), respectively. Rate of conclusive diagnosis was 95.6% (86/91). The commonest diagnosis encountered was nonalcoholic steatohepatitis) (23, 25.3%), followed by autoimmune hepatitis (17, 18.7%). Additional diagnostic information was obtained by endosonography during EUS-LB in 21 patients (23.1%). Gallstone disease was found in four (4.8%) patients, chronic calcific pancreatitis in two (1.9%) patients, significant abdominal lymphadenopathy defined as lymph node more than 1.5 cm in five (5.8%) patients, and esophageal or gastric varices in ten (10.6%) patients. One case of self-limiting biopsy site ooze was seen in EUS-LB and the patient was having cirrhosis.

Conclusion This study showed a high diagnostic outcome and safety profile with EUS-LB technique. EUS-LB can achieve excellent histological yield when performed with optimal technique. Moreover, it is possible to obtain additional information during the procedure from diagnostic endosonography that is done as a part of EUS-LB.

Keywords

EUS-LB - liver tissue - unmet need


Publication History

Article published online:
04 June 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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