BACKGROUND AND AIMS:
Liver biopsy (LB) has been traditionally performed by percutaneous (PC), transjugular (TJ) or surgical approaches. EUS-guided liver biopsy (EUS-LB) is an emerging method that has shown promise in terms of tissues yield and procedural safety. Comparison of histologic yield of EUS-LB to other methods of LB has not been done. This study aims to compare tissue yield of different LB methods.
EUS-LB, TJ-LB, and PC-LB procedures were identified retrospectively. EUS-LB- was obtained transgastric and transduodenal biopsy, or transgastric (left lobe) only using a 19-gauge FNA needle (non-Trucut). TJ-LB were obtained with an 18g or 19g needle, and PC -LB with an 18g or 20g needle. Stained slides were digitized on a whole slide scanner and total specimen length (TSL) and count of complete portal triads (CPT) was determined. Comparisons of TSL and CPT between the 3 groups were done with Wilcoxon rank-sum tests.
Wilcoxon rank-sum tests indicated that EUS-LB of both liver regions gave significantly more tissue in terms of both TSL and CPT compared with PC (p = 0.0000 and 0.0006). EUS-LB gave significantly higher TSL than that of TJ (p= 0.01) and similar CPT (p=0.22). Those EUS-LB cases that sampled the left lobe only were not statistically different compared with PC and TJ.
EUS-guided liver biopsy produces specimens at least comparable to, and in some cases better than PC or TJ biopsies. Widely separated liver regions can be easily sampled, which may provide some benefit. The role of EUS-LB is likely to increase in the future.