Diagnostic efficacy of endoscopic ultrasound-guided liver biopsy for diffuse liver diseases and its predictors - a multicentric retrospective analysis.

IF 1.5 Q3 GASTROENTEROLOGY & HEPATOLOGY
Clinical and Experimental Hepatology Pub Date : 2023-09-01 Epub Date: 2023-08-23 DOI:10.5114/ceh.2023.130618
Sridhar Sundaram, Bhavik Shah, Nitin Jagtap, Sumaswi Angadi, Aadish K Jain, Shivaraj Afzalpurkar, Suprabhat Giri
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引用次数: 0

Abstract

Aim of the study: Endoscopic ultrasound (EUS)-guided liver biopsy (LB) has become an increasingly popular method of tissue acquisition for evaluating liver diseases. Despite its advantages, EUS-LB has not been widely adopted in clinical practice due to concerns regarding efficacy and safety. Present data on EUS-LB from India are scarce. We aimed to study the diagnostic outcome and safety of EUS-guided liver biopsy.

Material and methods: This is a retrospective analysis of prospectively maintained data from January 2021 to October 2022 of consecutive patients undergoing EUS-LB at four tertiary care centers in India. The primary outcome was sample adequacy, while secondary outcomes were rate of successful pathological diagnoses and incidence of adverse events (AE).

Results: A total of 74 patients (median age: 44.5 years, 50.0% males) were included. The majority of the patients underwent left-lobe biopsy (62/74, 83.7%), and a 19-G Franseen FNB needle was most commonly used (61/74, 82.4%). Wet heparin suction was used in most cases (60/74, 81.1%). There were five mild AEs observed (one case of self-limited bleeding and four cases of post-procedural pain). Adequate and optimal samples were obtained in 71 (95.9%) and 49 (66.2%) cases, with a conclusive diagnosis being made in 97.3% (72/74) of the patients. On multivariate analysis, the presence of ascites was a negative predictor of optimal sample (odds ratio [OR] = 0.128, 95% CI: 0.017-0.96).

Conclusions: EUS-LB is a safe and viable alternative to percutaneous liver biopsy, achieving diagnosis in > 95% of cases. EUS-LB can be performed safely even in patients with mild ascites, although ascites reduces the chances of getting an optimal sample.

Abstract Image

内镜超声引导下肝活检对弥漫性肝病的诊断疗效及其预测因素——一项多中心回顾性分析。
研究目的:内镜超声(EUS)引导的肝活检(LB)已成为一种越来越流行的评估肝脏疾病的组织采集方法。尽管EUS-LB具有优势,但由于对疗效和安全性的担忧,它尚未在临床实践中被广泛采用。目前来自印度的EUS-LB数据很少。我们旨在研究EUS引导下肝活检的诊断结果和安全性。材料和方法:这是对2021年1月至2022年10月在印度四个三级护理中心接受EUS-LB的连续患者的前瞻性维护数据的回顾性分析。主要结果是样本充足性,次要结果是病理诊断成功率和不良事件发生率。结果:共有74名患者(中位年龄:44.5岁,50.0%为男性)被纳入。大多数患者接受了左叶活检(62/74,83.7%),最常用的是19-G Fransee FNB针(61/74,82.4%)。大多数病例使用湿肝素抽吸(60/74,81.1%)。观察到5例轻度AE(1例自限性出血,4例术后疼痛)。在71例(95.9%)和49例(66.2%)病例中获得了足够和最佳的样本,97.3%(72/74)的患者得到了明确的诊断。在多变量分析中,腹水的存在是最佳样本的阴性预测因素(比值比[OR]=0.128,95%CI:0.017-0.96)。结论:EUS-LB是经皮肝活检的一种安全可行的替代方案,在>95%的病例中实现诊断。即使在轻度腹水患者中也可以安全地进行EUS-LB,尽管腹水降低了获得最佳样本的机会。
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来源期刊
Clinical and Experimental Hepatology
Clinical and Experimental Hepatology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
2.80
自引率
0.00%
发文量
32
期刊介绍: Clinical and Experimental Hepatology – quarterly of the Polish Association for Study of Liver – is a scientific and educational, peer-reviewed journal publishing original and review papers describing clinical and basic investigations in the field of hepatology.
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