Mok Shaffer R S, Diehl David L
Case Western Reserve University-School of Medicine, Cleveland, OH, USA.
Department of Gastroenterology and Nutrition, Geisinger Medical Center, 100 N. Academy Ave, 21-11, Danville, PA, 17822, USA.
Curr Gastroenterol Rep. 2019 Jan 31;21(2):6. doi: 10.1007/s11894-019-0675-8.
EUS-guided liver biopsy (EUS-LB) is being used with increased frequency to perform parenchymal liver biopsy. Evolution of the technique can now achieve excellent liver tissue cores. This review covers important developments in this procedure.
Clinical studies have recently demonstrated that the 19G EUS core biopsy needle is superior to non-core needles for liver tissue acquisition. In addition, wet suction provides more robust tissue samples than dry suction. Heparin priming of the needle (instead of saline) can prevent blood clogging within the needle lumen. A 1-hour recovery time after the EUS-LB is sufficient in almost all cases. The EUS-LB can deliver bilobar biopsies, which can decrease sampling error. Patients who need a liver biopsy in addition to an endoscopy or EUS are best served by the EUS-LB, as the combination procedure saves time and cost. The EUS-LB is a safe and effective means for procuring good liver core biopsies. Incremental improvements in technique have increased quality of the resulting specimen. Future directions of this technique are discussed.
超声内镜引导下肝活检（EUS-LB）用于实质肝活检的频率日益增加。该技术的发展现已能获取优质的肝组织样本。本综述涵盖了该操作的重要进展。
临床研究最近表明，19G超声内镜活检针在获取肝组织方面优于非活检针。此外，湿法抽吸比干法抽吸能提供更可靠的组织样本。用肝素（而非生理盐水）预充活检针可防止针腔内血液堵塞。几乎在所有情况下，超声内镜引导下肝活检后1小时的恢复时间就足够了。超声内镜引导下肝活检可进行双侧活检，这能减少采样误差。除了内镜检查或超声内镜检查外还需要进行肝活检的患者，采用超声内镜引导下肝活检最为合适，因为联合操作节省时间和成本。超声内镜引导下肝活检是获取优质肝组织样本的安全有效方法。技术上的逐步改进提高了所获标本的质量。本文还讨论了该技术的未来发展方向。
