High yield of same-session EUS-guided liver biopsy by 19-gauge FNA needle in patients undergoing EUS to exclude biliary obstruction - 15/01/12
Reprint requests: Stavros N. Stavropoulos, MD, 222 Station Plaza North, Suite 428, Mineola, NY, USA 11501Résumé |
Background |
EUS-guided liver biopsy by Trucut yields variable specimen adequacy at high cost, limiting its utility. A modified EUS-guided technique with reliable adequacy could be a viable alternative to standard techniques in cost-effective clinical settings.
Objective |
To describe our experience with EUS-guided liver biopsy by 19-gauge FNA, non-Trucut, needle in a cost-effective setting: patients with abnormal liver test results of unclear etiology referred for EUS to exclude biliary obstruction in whom an unrevealing EUS would have prompted a next-step liver biopsy by the referring physician.
Design |
Prospective case series.
Setting |
Tertiary-care teaching hospital.
Patients |
Consecutive patients with abnormal liver tests referred for EUS.
Interventions |
EUS-guided liver biopsy by 19-gauge FNA needle (non-Trucut).
Main Outcome Measurements |
Diagnostic yield, specimen adequacy, and complications. An adequate specimen was defined as a length of 15 mm or longer and 6 or more complete portal tracts (CPTs).
Results |
Between July 2008 and July 2011, 22 of 31 consecutive patients meeting inclusion criteria underwent unrevealing EUS with same-session EUS-guided liver biopsy by 19-gauge FNA needle. A median of 2 FNA passes (range 1-3) yielded a median specimen length of 36.9 mm (range 2-184.6 mm) with a median of 9 CPTs (range 1-73 CPTs). EUS-guided liver biopsies yielded a histologic diagnosis and adequate specimens in 20 of 22 patients (91%). Expanded experience led to improved specimen adequacy. There were no complications.
Limitation |
Small study size.
Conclusions |
EUS-guided liver biopsy by using a 19-gauge FNA needle appears to be feasible and safe and provides excellent diagnostic yield and specimen adequacy.
Le texte complet de cet article est disponible en PDF.Abbreviations : CPT, EUS-FNA, INR
Plan
| DISCLOSURE: The authors disclosed no financial relationships relevant to this publication. |
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| If you would like to chat with an author of this article, you may contact Dr. Stavropoulos at sstavropoulos@winthrop.org. |
Vol 75 - N° 2
P. 310-318 - février 2012 Retour au numéro
Article précédent
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