Skip to main content
Erschienen in: Digestive Diseases and Sciences 11/2022

15.02.2022 | Original Article

“Wet Heparin” and “Wet Saline” EUS-Guided Liver Biopsy Techniques Both Provide High Rates of Specimen Adequacy for Benign Parenchymal Liver Disease

verfasst von: Hamzeh Saraireh, Thaer Abdelfattah, Ramzi Hassouneh, Robert Lippman, Puneet Puri, Pritesh Mutha, Simran Singh, Michael Fuchs, Tilak Shah

Erschienen in: Digestive Diseases and Sciences | Ausgabe 11/2022

Einloggen, um Zugang zu erhalten

Abstract

Background

Endoscopic ultrasound-guided liver biopsy (EUS-LB) has emerged as a viable mean to obtain core tissue, but the optimal tools and techniques are still an area of active investigation.

Aims

(1) To compare tissue adequacy using “wet saline” (WS) vs. “wet heparin” (WH) technique (2) To compare post-procedure pain between EUS-LB and percutaneous liver biopsy (PLB).

Methods

Retrospective review of consecutive patients who underwent EUS-LB and PLB for benign parenchymal liver disease between May 2017 to October 2019 at a single tertiary veterans affairs medical center.

Results

About 257 biopsies from 217 patients were included. Among the 102 EUS-LB specimens, 53 were obtained using WS technique and 49 were obtained using WH technique. Specimen adequacy was similar in both groups. Median Aggregate Specimen Length (ASL) and length of longest piece did not differ significantly between WS and WH groups. Clots were present more frequently in the WS group. Among patients who underwent EUS-LB of both right and left liver lobes, an adequate biopsy was obtained in 85% of patients in the WS group and 96% of patients in the WH group. The percentage of patients experiencing immediate post-procedure pain was higher with PLB compared to EUS-LB, but these results were not statistically significant.

Conclusions

Both WS and WH EUS-LB techniques can offer high rates of specimen adequacy with low rates of pain and other post-procedure complications.
Literatur
1.
Zurück zum Zitat Rockey DC, Caldwell SH, Goodman ZD, Nelson RC, Smith AD. Diseases AAftSoL. Liver biopsy. Hepatology. 2009;49:1017–1044.CrossRef Rockey DC, Caldwell SH, Goodman ZD, Nelson RC, Smith AD. Diseases AAftSoL. Liver biopsy. Hepatology. 2009;49:1017–1044.CrossRef
2.
Zurück zum Zitat Nalbantoglu IL, Brunt EM. Role of liver biopsy in nonalcoholic fatty liver disease. World J Gastroenterol. 2014;20:9026–9037.PubMedPubMedCentral Nalbantoglu IL, Brunt EM. Role of liver biopsy in nonalcoholic fatty liver disease. World J Gastroenterol. 2014;20:9026–9037.PubMedPubMedCentral
3.
Zurück zum Zitat Castéra L, Nègre I, Samii K, Buffet C. Patient-administered nitrous oxide/oxygen inhalation provides safe and effective analgesia for percutaneous liver biopsy: a randomized placebo-controlled trial. Am J Gastroenterol. 2001;96:1553–1557.CrossRef Castéra L, Nègre I, Samii K, Buffet C. Patient-administered nitrous oxide/oxygen inhalation provides safe and effective analgesia for percutaneous liver biopsy: a randomized placebo-controlled trial. Am J Gastroenterol. 2001;96:1553–1557.CrossRef
4.
Zurück zum Zitat Meng HC, Lin HC, Huang CC et al. Transjugular liver biopsy: comparison with percutaneous liver biopsy. J Gastroenterol Hepatol. 1994;9:457–461.CrossRef Meng HC, Lin HC, Huang CC et al. Transjugular liver biopsy: comparison with percutaneous liver biopsy. J Gastroenterol Hepatol. 1994;9:457–461.CrossRef
5.
Zurück zum Zitat Diehl DL, Johal AS, Khara HS et al. Endoscopic ultrasound-guided liver biopsy: a multicenter experience. Endosc Int Open. 2015;3:E210-215.CrossRef Diehl DL, Johal AS, Khara HS et al. Endoscopic ultrasound-guided liver biopsy: a multicenter experience. Endosc Int Open. 2015;3:E210-215.CrossRef
6.
Zurück zum Zitat Mohan BP, Shakhatreh M, Garg R, Ponnada S, Adler DG. Efficacy and safety of EUS-guided liver biopsy: a systematic review and meta-analysis. Gastrointest Endosc. 2019;89:238-246.e233.CrossRef Mohan BP, Shakhatreh M, Garg R, Ponnada S, Adler DG. Efficacy and safety of EUS-guided liver biopsy: a systematic review and meta-analysis. Gastrointest Endosc. 2019;89:238-246.e233.CrossRef
7.
Zurück zum Zitat Attam R, Arain MA, Bloechl SJ et al. “Wet suction technique (WEST)”: a novel way to enhance the quality of EUS-FNA aspirate. Results of a prospective, single-blind, randomized, controlled trial using a 22-gauge needle for EUS-FNA of solid lesions. Gastrointest Endosc. 2015;81:1401–1407.CrossRef Attam R, Arain MA, Bloechl SJ et al. “Wet suction technique (WEST)”: a novel way to enhance the quality of EUS-FNA aspirate. Results of a prospective, single-blind, randomized, controlled trial using a 22-gauge needle for EUS-FNA of solid lesions. Gastrointest Endosc. 2015;81:1401–1407.CrossRef
8.
Zurück zum Zitat Kleiner DE, Brunt EM, Van Natta M et al. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology. 2005;41:1313–1321.CrossRef Kleiner DE, Brunt EM, Van Natta M et al. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology. 2005;41:1313–1321.CrossRef
9.
Zurück zum Zitat Bedossa P. Histological Assessment of NAFLD. Dig Dis Sci. 2016;61:1348–1355.CrossRef Bedossa P. Histological Assessment of NAFLD. Dig Dis Sci. 2016;61:1348–1355.CrossRef
11.
Zurück zum Zitat Nieto J, Dawod E, Deshmukh A, Penn E, Adler D, Saab S. EUS-guided fine-needle core liver biopsy with a modified one-pass, one-actuation wet suction technique comparing two types of EUS core needles. Endosc Int Open. 2020;8:E938–E943.CrossRef Nieto J, Dawod E, Deshmukh A, Penn E, Adler D, Saab S. EUS-guided fine-needle core liver biopsy with a modified one-pass, one-actuation wet suction technique comparing two types of EUS core needles. Endosc Int Open. 2020;8:E938–E943.CrossRef
12.
Zurück zum Zitat Hasan MK, Kadkhodayan K, Idrisov E et al. Endoscopic ultrasound-guided liver biopsy using a 22-G fine needle biopsy needle: a prospective study. Endoscopy. 2019;51:818–824.CrossRef Hasan MK, Kadkhodayan K, Idrisov E et al. Endoscopic ultrasound-guided liver biopsy using a 22-G fine needle biopsy needle: a prospective study. Endoscopy. 2019;51:818–824.CrossRef
13.
Zurück zum Zitat Ali AH, Panchal S, Rao DS et al. The efficacy and safety of endoscopic ultrasound-guided liver biopsy versus percutaneous liver biopsy in patients with chronic liver disease: a retrospective single-center study. J Ultrasound. 2020;23:157–167.CrossRef Ali AH, Panchal S, Rao DS et al. The efficacy and safety of endoscopic ultrasound-guided liver biopsy versus percutaneous liver biopsy in patients with chronic liver disease: a retrospective single-center study. J Ultrasound. 2020;23:157–167.CrossRef
Metadaten
Titel
“Wet Heparin” and “Wet Saline” EUS-Guided Liver Biopsy Techniques Both Provide High Rates of Specimen Adequacy for Benign Parenchymal Liver Disease
verfasst von
Hamzeh Saraireh
Thaer Abdelfattah
Ramzi Hassouneh
Robert Lippman
Puneet Puri
Pritesh Mutha
Simran Singh
Michael Fuchs
Tilak Shah
Publikationsdatum
15.02.2022
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 11/2022
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-022-07399-7

Weitere Artikel der Ausgabe 11/2022

Digestive Diseases and Sciences 11/2022 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Erhöhte Mortalität bei postpartalem Brustkrebs

07.05.2024 Mammakarzinom Nachrichten

Auch für Trägerinnen von BRCA-Varianten gilt: Erkranken sie fünf bis zehn Jahre nach der letzten Schwangerschaft an Brustkrebs, ist das Sterberisiko besonders hoch.

Hypertherme Chemotherapie bietet Chance auf Blasenerhalt

07.05.2024 Harnblasenkarzinom Nachrichten

Eine hypertherme intravesikale Chemotherapie mit Mitomycin kann für Patienten mit hochriskantem nicht muskelinvasivem Blasenkrebs eine Alternative zur radikalen Zystektomie darstellen. Kölner Urologen berichten über ihre Erfahrungen.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Medizinstudium Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Vorhofflimmern bei Jüngeren gefährlicher als gedacht

06.05.2024 Vorhofflimmern Nachrichten

Immer mehr jüngere Menschen leiden unter Vorhofflimmern. Betroffene unter 65 Jahren haben viele Risikofaktoren und ein signifikant erhöhtes Sterberisiko verglichen mit Gleichaltrigen ohne die Erkrankung.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.