Optimal techniques for obtaining superior liver specimens at endoscopic ultrasound-guided biopsy: a pilot study on pigs.

IF 4.2 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterology Report Pub Date : 2025-07-03 eCollection Date: 2025-01-01 DOI:10.1093/gastro/goaf062

Ying Wu, Ni Xie, Guanhao Su, Ying Qu, Jianbo Ni, Kui Peng, Yiran Song, Wen Wen, Baiwen Li

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引用次数: 0

Abstract

Background: Endoscopic ultrasound (EUS)-guided liver biopsy has been an effective method for acquiring liver tissue. However, currently, there is no consensus on the technical details of biopsy sampling. This study aimed to optimize the EUS-guided liver biopsy techniques to improve specimen quality.

Methods: EUS-guided liver biopsies were performed in four porcine subjects with four technical aspects: negative pressure suction, number of actuations, two puncture manipulations, and two types of puncture needles. The primary outcomes were total specimen length (TSL) and complete portal tracts (CPTs), the secondary outcomes included longest specimen length (LSL), number of specimen pieces, specimen fragmentation, blood contamination, and bleeding.

Results: Forty-four biopsy samplings were performed. In Phase I, specimens obtained with 1-mL suction demonstrated significantly superior TSL, CPTs, and LSL compared with other suction techniques according to multiple comparisons. In Phase II, median TSL and CPTs with fewer than three actuations were significantly higher compared with those with at least three actuations (P < 0.05). In Phase III, the modified "click-puncture" yielded superior median CPTs, TSL, and LSL in comparison with conventional puncture (P < 0.05). In Phase IV, a fine-needle aspiration (FNA) needle was effective with a low risk of bleeding and foreign-tissue embedding (P < 0.05).

Conclusions: Optimal techniques for specimen quality in EUS-guided liver biopsy include using 1-mL suction, no more than three actuations, and employing a modified "click-puncture" manipulation. While FNA and fine-needle biopsy needles achieved comparable specimen quality, the FNA needle demonstrated the prevention of bleeding and foreign-tissue embedding.

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在超声内镜引导下获得优质肝脏标本的最佳技术：对猪的初步研究。

背景：超声内镜（EUS）引导下的肝活检是获取肝组织的有效方法。然而，目前对于活检取样的技术细节尚未达成共识。本研究旨在优化eus引导下的肝活检技术，以提高标本质量。方法：采用负压吸引、穿刺次数、两种穿刺手法、两种穿刺针等4个技术方面对4只猪进行肝穿刺活检。主要指标为总标本长度（TSL）和完整门静脉束（CPTs），次要指标为最长标本长度（LSL）、标本片数、标本碎裂、血液污染和出血。结果：进行了44例活检。在I期试验中，通过多次比较，采用1ml吸痰方法获得的标本与其他吸痰方法相比，TSL、CPTs和LSL均有显著优势。在II期，少于3次驱动的中位TSL和cpt显著高于至少3次驱动的中位TSL和cpt （P < 0.05）。在III期，改良的“点击穿刺”与常规穿刺相比，获得了更高的中位CPTs、TSL和LSL （P < 0.05）。在IV期，细针抽吸（FNA）针是有效的，出血和异物组织包埋的风险较低（p0.05）。结论：eus引导下肝活检标本质量的最佳技术包括1ml抽吸，不超过3次驱动，并采用改良的“点击穿刺”操作。虽然FNA和细针活检针的标本质量相当，但FNA针刺可预防出血和异物组织嵌入。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gastroenterology Report Medicine-Gastroenterology

CiteScore

4.60

自引率

2.80%

发文量

审稿时长

8 weeks

期刊介绍： Gastroenterology Report is an international fully open access (OA) online only journal, covering all areas related to gastrointestinal sciences, including studies of the alimentary tract, liver, biliary, pancreas, enteral nutrition and related fields. The journal aims to publish high quality research articles on both basic and clinical gastroenterology, authoritative reviews that bring together new advances in the field, as well as commentaries and highlight pieces that provide expert analysis of topical issues.