内窥镜超声引导肝活检（EUS-LB）：满足肝组织采集及其他未满足需求的内窥镜解决方案

IF 0.4 Q4 GASTROENTEROLOGY & HEPATOLOGY

Journal of Digestive Endoscopy Pub Date : 2024-06-04 DOI:10.1055/s-0044-1785498

Shivam Khare, A. Arora, Jijo Varghese, Ashish Kumar, Sunila Jain, Ashiesh Khandelwal, Arpita Mittal, Sunayana Misra, S. Anikhindi, Mandhir Kumar, P. Ranjan, Praveen Sharma, Naresh Bansal, M. Sachdeva, S. Giri, Srijaya S.

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引用次数: 0

摘要

目的和目标内窥镜超声引导肝活检（EUS-LB）作为一种获取肝组织的方法，目前在全球范围内得到越来越广泛的应用。这种方法克服了经皮肝穿刺活检和经颈静脉肝穿刺活检的许多缺点，因此被许多专业人士广泛接受。本研究旨在获得与 EUS-LB 相关的适当和最佳活检率。材料和方法这是一项回顾性观察研究。在研究期间，连续接受 EUS-LB 检查并愿意同意的患者均被纳入研究对象。结果共有 91 名患者参与研究。研究对象的中位年龄为 44 岁，其中男性 39 人，女性 52 人（分别占 42.9% 和 57.1%）。充分活检率（根据欧洲肝病研究协会标准）和最佳活检率（根据美国肝病研究协会标准）分别为 89 (81/91) 和 60.4% (55/91)。确诊率为 95.6%（86/91）。最常见的诊断是非酒精性脂肪性肝炎（23，25.3%），其次是自身免疫性肝炎（17，18.7%）。有 21 名患者（23.1%）通过 EUS-LB 期间的内镜检查获得了其他诊断信息。4例（4.8%）患者发现胆石症，2例（1.9%）患者发现慢性钙化性胰腺炎，5例（5.8%）患者发现明显的腹部淋巴结肿大，即淋巴结超过1.5厘米，10例（10.6%）患者发现食管或胃静脉曲张。有一例患者在 EUS-LB 检查中发现活检部位有自限性渗液，该患者患有肝硬化。结论本研究显示 EUS-LB 技术具有较高的诊断效果和安全性。如果采用最佳技术，EUS-LB 可获得极佳的组织学结果。此外，作为 EUS-LB 的一部分，还可在手术过程中通过诊断性内窥镜检查获得更多信息。

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Endoscopic Ultrasound-Guided Liver Biopsy (EUS-LB): An Endoscopic Solution to the Unmet Needs of Liver Tissue Acquisition and Beyond

Aim and Objective Endoscopic ultrasound-guided liver biopsy (EUS-LB) is now increasingly being used across the globe as a method of liver tissue acquisition. This method is widely accepted by many professionals as it can overcome many shortcomings of percutaneous liver biopsy and transjugular liver biopsy. The aim of the study is to obtain the adequate and optimal biopsy rate associated with EUS-LB. Materials and Methods This is a retrospective observational study. Consecutive patients undergoing EUS-LB during the study period who were willing to consent were taken up for the study. Results Total 91 patients were taken up for the study. Median age of study population was 44 years out of which 39 patients were males and 52 were females (42.9 and 57.1%). Adequate biopsy rate (according to European Association for the Study of Liver Disease criteria) and optimal biopsy rate (according to American Association for the Study of Liver Diseases criteria) were 89 (81/91) and 60.4% (55/91), respectively. Rate of conclusive diagnosis was 95.6% (86/91). The commonest diagnosis encountered was nonalcoholic steatohepatitis) (23, 25.3%), followed by autoimmune hepatitis (17, 18.7%). Additional diagnostic information was obtained by endosonography during EUS-LB in 21 patients (23.1%). Gallstone disease was found in four (4.8%) patients, chronic calcific pancreatitis in two (1.9%) patients, significant abdominal lymphadenopathy defined as lymph node more than 1.5 cm in five (5.8%) patients, and esophageal or gastric varices in ten (10.6%) patients. One case of self-limiting biopsy site ooze was seen in EUS-LB and the patient was having cirrhosis. Conclusion This study showed a high diagnostic outcome and safety profile with EUS-LB technique. EUS-LB can achieve excellent histological yield when performed with optimal technique. Moreover, it is possible to obtain additional information during the procedure from diagnostic endosonography that is done as a part of EUS-LB.

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来源期刊

Journal of Digestive Endoscopy GASTROENTEROLOGY & HEPATOLOGY-

自引率

28.60%

发文量

审稿时长

22 weeks

期刊介绍： The Journal of Digestive Endoscopy (JDE) is the official publication of the Society of Gastrointestinal Endoscopy of India that has over 1500 members. The society comprises of several key clinicians in this field from different parts of the country and has key international speakers in its advisory board. JDE is a double-blinded peer-reviewed, print and online journal publishing quarterly. It focuses on original investigations, reviews, case reports and clinical images as well as key investigations including but not limited to cholangiopancreatography, fluoroscopy, capsule endoscopy etc.