Borland Groover Clinic, Jacksonville, Florida, USA; Baptist Medical Center, Jacksonville, Florida, USA.
Department of Surgery, University of California at Los Angeles, Los Angeles, California, USA.
Gastrointest Endosc. 2018 Feb;87(2):469-475. doi: 10.1016/j.gie.2017.05.013. Epub 2017 May 24.
EUS-guided fine-needle core biopsy sampling is a safe and effective technique for diagnosis of focal liver lesions. However, data are limited in its role in parenchymal disease. We evaluated the utility of EUS-guided parenchymal liver biopsy sampling with a modified 1-pass wet suction technique (EUS-modified liver biopsy sampling [EUS-MLB]) in patients with unexplained increase in liver-associated tests.
We retrospectively evaluated the safety and efficacy of EUS-MLB in patients referred for EUS to evaluate for biliary obstruction and pancreatic disorders but with associated unexplained liver tests. EUS-MLB was performed during the same session after biliary obstruction was excluded.
One hundred sixty-five consecutive patients underwent EUS-MLB. The median age was 52 years (interquartile range [IQR], 42-65). Sixty-eight patients (41%) were men. The median of the maximum intact core tissue length was 2.4 cm (IQR, 1.8-3.5). The median total specimen length (TSL) was 6 cm (IQR, 4.3-8). The median number of complete portal tracts (CPTs) per TSL was 18 (IQR, 13- 24). The mean number of CPTs per sample length was 7.5 cm. Adverse events were uncommon (1.8%) and included abdominal pain and self-limited hematoma.
EUS-guided fine-needle biopsy sampling using a novel 19-gauge core needle with a modified 1-pass 1 actuation wet suction technique (EUS-MLB) is a safe and effective way to evaluate patients with unexplained liver tests abnormalities who are undergoing EUS for exclusion of biliary obstruction.
EUS 引导下的细针核心活检采样是一种安全有效的方法，可用于诊断局灶性肝脏病变。然而，其在实质疾病中的作用的数据有限。我们评估了改良的 1 次通过湿抽吸技术（EUS 改良肝活检采样 [EUS-MLB]）在因不明原因的肝相关检查异常而接受 EUS 检查以排除胆道梗阻和胰腺疾病的患者中的效用。
我们回顾性评估了 EUS-MLB 在因胆道梗阻和胰腺疾病而接受 EUS 检查的患者中的安全性和有效性，这些患者伴有不明原因的肝相关检查异常。在排除胆道梗阻后，在同一检查中进行 EUS-MLB。
165 例连续患者接受了 EUS-MLB。中位年龄为 52 岁（四分位距 [IQR]，42-65）。68 例（41%）为男性。最大完整核心组织长度的中位数为 2.4 厘米（IQR，1.8-3.5）。总标本长度（TSL）的中位数为 6 厘米（IQR，4.3-8）。中位数每 TSL 的完整门脉小叶数为 18（IQR，13-24）。每样本长度的完整门脉小叶数的中位数为 7.5 厘米。不良事件罕见（1.8%），包括腹痛和自限性血肿。
使用新型 19 号活检针和改良的 1 次通过 1 次启动湿抽吸技术（EUS-MLB）进行 EUS 引导下细针活检采样是一种安全有效的方法，可用于评估因不明原因的肝检查异常而接受 EUS 检查以排除胆道梗阻的患者。
