Endoscopic Ultrasound-Guided Liver Biopsy Using Newer 19G FNB Needles Compared to Percutaneous and Transjugular Liver Biopsy: A Tertiary Center Experience

Abstract

Background and AimsEndoscopic ultrasound guided fine needle biopsy of the liver (EUS-LB) has emerged as a safe technique to obtain liver tissue for diagnosis of parenchymal liver disease. In this study, we compare the specimen quality, complication rates and recovery times in EUS-LB vs percutaneous (PC-LB) and transjugular (TJ-LB) routes. MethodsThis is a single center retrospective study comparing EUS-LB (19-G core needle) to PC-LB (16-G needle) and TJ-LB (19-G needle). Primary outcome was the number of complete portal tracts (CPT). Secondary outcomes were: aggregate specimen length (AL), mean length of longest intact core (LIC), postprocedure recovery time, and adverse events. ResultsA total of 92 procedures were included in this study. Fewer needle passes were performed in EUS-LB group and PC-LB group compared to TJ-LB group (P < 0.001). EUS-LB produced more CPTs than PC-LB (P < 0.001) and similar number of CPT to TJ-LB (P > 0.05). EUS-LB produced significantly higher AL than both PC-LB (P = 0.03) and TJ-LB (P = 0.02). LIC with EUS-LB was higher than TJ-LB (P = 0.04) but similar to PC-LB (P = 0.23). Postprocedural recovery time was less after EUS-LB compared to PC-LB (P < 0.001) and TJ-LB (P = 0.04). Postprocedure adverse events were rare, and similar across the 3 groups. ConclusionEUS-LB produced better or similar specimens with fewer needle passes and lesser postprocedural recovery time when compared with PC-LB and TJ-LB. EUS-LB should be the preferred technique for liver biopsy when patients also need an upper endoscopy.