Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226 014, India.
Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226 014, India.
Indian J Gastroenterol. 2023 Jun;42(3):418-424. doi: 10.1007/s12664-023-01339-7. Epub 2023 Apr 25.
Endoscopic ultrasound-guided liver biopsy (EUS-LB) is considered to be safe and effective. Commonly a 19-G fine-needle aspiration or biopsy needle is used. But, the results vary with different techniques that are used. Herein, we report the results of liver biopsy with a single-pass, three actuations (1:3) using the slow-pull technique.
In this prospective study, 50 consecutive patients with indications for liver biopsy underwent EUS-LB with a 19-gauge fine-needle biopsy (FNB) needle from both right and left lobes. The primary outcome was the adequacy of the specimen for histological diagnosis. Total specimen length (TSL), longest specimen length (LSL), complete portal tracts (CPTs) and comparison of these outcomes between the left lobe and right lobe specimens were secondary outcomes. Adverse events (AEs) were also measured during this study.
Adequate tissue for histological diagnosis was obtained in all 50 patients (100%). The median number of CPTs was 32.5 (range, 11-58), while the median of TSL was 58 mm (range, 35-190) and the median LSL was 15 mm (range, 5-40). There was no significant difference in CPTs, TSL and LSL between left and right lobe biopsies. There was no major complication; one of the patients (2%) had bleed from the duodenal puncture site, which was managed endoscopically without the need for blood transfusion.
Endoscopic ultrasound-guided liver biopsy using a 19-gauge Franseen tip needle with a single pass, three actuation (1:3) and slow-pull technique provides adequate tissue yield and has a good safety profile.
经内镜超声引导的肝脏活检（EUS-LB）被认为是安全有效的。通常使用 19-G 细针抽吸或活检针进行。但是，结果因使用的技术不同而有所不同。在此，我们报告使用单次通过、三次操作（1:3）和缓慢牵拉技术进行肝脏活检的结果。
在这项前瞻性研究中，50 例有肝脏活检适应证的连续患者均接受了 EUS-LB，使用了 19-G 细针活检（FNB）针从左右叶进行。主要结局是组织学诊断的标本充足度。总标本长度（TSL）、最长标本长度（LSL）、完整的门管区（CPTs）以及这些结果在左叶和右叶标本之间的比较是次要结局。在这项研究中还测量了不良事件（AEs）。
所有 50 例患者（100%）均获得了组织学诊断的充足标本。中位数 CPTs 为 32.5（范围，11-58），TSL 中位数为 58 mm（范围，35-190），LSL 中位数为 15 mm（范围，5-40）。左叶和右叶活检的 CPTs、TSL 和 LSL 无显著差异。无重大并发症；1 例患者（2%）出现十二指肠穿刺部位出血，经内镜治疗，无需输血。
使用单次通过、三次操作（1:3）和缓慢牵拉技术的 19-G 号 Franseen 尖端针进行 EUS-LB 可提供充足的组织产量，且具有良好的安全性。
