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ISSN: 2392-1099
Clinical and Experimental Hepatology
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3/2023
vol. 9
 
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abstract:
Original paper

Diagnostic efficacy of endoscopic ultrasound-guided liver biopsy for diffuse liver diseases and its predictors – a multicentric retrospective analysis

Sridhar Sundaram
1
,
Bhavik Shah
2, 3
,
Nitin Jagtap
4
,
Sumaswi Angadi
5
,
Aadish K. Jain
1
,
Shivaraj Afzalpurkar
6
,
Suprabhat Giri
5

  1. Department of Digestive Disease and Clinical Nutrition, Tata Memorial Hospital, Mumbai, India
  2. Department of Gastroenterology, Shree Narayana Hospital, Raipur, India
  3. Department of Gastroenterology, MediGenix Hospital, Raipur, India
  4. Department of Gastroenterology, Asian Institute of Gastroenterology, Somajiguda, Hyderabad, India
  5. Department of Gastroenterology, Nizam’s Institute of Medical Sciences, Hyderabad, India
  6. Department of Gastroenterology, Nanjappa Multispecialty Hospital, Davangere, India
Clin Exp HEPATOL 2023; 9, 3: 243-250
DOI: https://doi.org/10.5114/ceh.2023.130618
Online publish date: 2023/08/23
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Aim of the study:
Endoscopic ultrasound (EUS)-guided liver biopsy (LB) has become an increasingly popular method of tissue acquisition for evaluating liver diseases. Despite its advantages, EUS-LB has not been widely adopted in clinical practice due to concerns regarding efficacy and safety. Present data on EUS-LB from India are scarce. We aimed to study the diagnostic outcome and safety of EUS-guided liver biopsy.

Material and methods:
his is a retrospective analysis of prospectively maintained data from January 2021 to October 2022 of consecutive patients undergoing EUS-LB at four tertiary care centers in India. The primary outcome was sample adequacy, while secondary outcomes were rate of successful pathological diagnoses and incidence of adverse events (AE).

Results:
A total of 74 patients (median age: 44.5 years, 50.0% males) were included. The majority of the patients underwent left-lobe biopsy (62/74, 83.7%), and a 19-G Franseen FNB needle was most commonly used (61/74, 82.4%). Wet heparin suction was used in most cases (60/74, 81.1%). There were five mild AEs observed (one case of self-limited bleeding and four cases of post-procedural pain). Adequate and optimal samples were obtained in 71 (95.9%) and 49 (66.2%) cases, with a conclusive diagnosis being made in 97.3% (72/74) of the patients. On multivariate analysis, the presence of ascites was a negative predictor of optimal sample (odds ratio [OR] = 0.128, 95% CI: 0.017-0.96).

Conclusions:
EUS-LB is a safe and viable alternative to percutaneous liver biopsy, achieving diagnosis in > 95% of cases. EUS-LB can be performed safely even in patients with mild ascites, although ascites reduces the chances of getting an optimal sample.

keywords:

endoscopic ultrasound, liver biopsy, fine needle biopsy, fine needle aspiration, parenchymal liver disease
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