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临床实践中的内镜超声引导下肝活检

Endoscopic Ultrasound-Guided Liver Biopsy in Clinical Practice.

作者信息

Sarkar Avik, Dellatore Peter, Bhurwal Abhishek, Tyberg Amy, Shahid Haroon, Minacapelli Carlos D, Kahaleh Michel, Rustgi Vinod K, Nieto Jose

机构信息

Division of Gastroenterology and Hepatology, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.

Center for Liver Diseases and Masses, Rutgers Robert Wood Johnson School of Medicine, New Brunswick, New Jersey.

出版信息

Gastro Hep Adv. 2022 Jul 19;1(6):936-941. doi: 10.1016/j.gastha.2022.07.007. eCollection 2022.

Abstract

BACKGROUND AND AIMS

Liver biopsies are traditionally performed using percutaneous, transjugular, or surgical approaches. Endoscopic ultrasound (EUS)-guided liver biopsy is a new modality to sample liver parenchyma. This technique allows sampling of both liver lobes and obviates the need for sampling error. However, there is paucity of literature demonstrating that EUS-guided liver biopsy provides adequate tissue sample for histologic analysis. This study aimed to review the experience of 2 large tertiary care centers to demonstrate the efficacy and safety of EUS-guided liver biopsy.

METHODS

All patients undergoing EUS-guided liver biopsy between March 2018 and October 2019 between 2 tertiary care centers were included in this retrospective study. The main outcomes of the study included technical success of EUS-guided liver biopsy, details of the specimen (length of the specimen, number of complete portal tracts), and adverse events of EUS-guided liver biopsy.

RESULTS

A total of 229 patients underwent EUS-guided liver biopsy at the 2 tertiary care centers. There was 100% technical success. Of the 229 patients, 226 patients (98.7%) had adequate tissue for histopathological evaluation with a mean total length of 3.20 cm and complete portal tracts of 20.2. Overall, 2.6% of patients had adverse events.

CONCLUSION

Our study illustrates that EUS-guided liver biopsy provides adequate specimen for histologic analysis and is a safe, viable alternative to other methods of liver biopsy.

摘要

背景与目的

传统上,肝活检采用经皮、经颈静脉或手术途径进行。内镜超声(EUS)引导下肝活检是一种获取肝实质样本的新方法。该技术能够对两个肝叶进行取样,避免了取样误差。然而,鲜有文献表明EUS引导下肝活检能提供足够的组织样本用于组织学分析。本研究旨在回顾两家大型三级医疗中心的经验,以证明EUS引导下肝活检的有效性和安全性。

方法

本回顾性研究纳入了2018年3月至2019年10月期间在两家三级医疗中心接受EUS引导下肝活检的所有患者。研究的主要结果包括EUS引导下肝活检的技术成功率、标本细节(标本长度、完整门静脉分支数量)以及EUS引导下肝活检的不良事件。

结果

两家三级医疗中心共有229例患者接受了EUS引导下肝活检。技术成功率为100%。在229例患者中,226例(98.7%)有足够的组织用于组织病理学评估,平均总长度为3.20 cm,完整门静脉分支数量为20.2个。总体而言,2.6%的患者发生了不良事件。

结论

我们的研究表明,EUS引导下肝活检能提供足够的标本用于组织学分析,是一种安全、可行的肝活检替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/577a/11308829/dc5987d8a272/gr1.jpg

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