Our Summary

This research paper is a detailed study of a technique called endoscopic ultrasound-guided liver biopsy (EUS-LB), which is a new method for sampling liver tissue. This technique is used to diagnose liver diseases and conditions. The researchers looked at how different types of needles used in the procedure can affect the results and safety of the biopsy.

They reviewed 33 previous studies on this topic up to October 2021. They found that the EUS-LB technique could successfully diagnose liver conditions in 95% of cases, produced a sufficient amount of tissue for testing in 84% of cases, and was considered safe, with adverse events happening only in 3% of cases.

They also found that the type of needle used can impact the results. A type of needle called “Acquire” was found to be more effective in diagnosing liver conditions than another type called “SharkCore”. However, another type of needle called “FNB” was found to increase the risk of adverse events compared to the “FNA” type.

Furthermore, they found that the criteria used to judge whether a sample of liver tissue is adequate for testing can greatly affect the results. The criteria set by the American Association for the Study of Liver Diseases (AASLD) is more challenging to meet than the commonly used criteria, making it seem like fewer samples are adequate for testing.

In conclusion, the EUS-LB technique is effective and safe for liver biopsy. The type of needle used and the criteria for judging sample adequacy can impact the results.

FAQs

  1. What is the diagnostic yield and specimen adequacy rate for endoscopic ultrasound-guided liver biopsy (EUS-LB)?
  2. Does the type of needle used in EUS-LB affect the performance and safety of the procedure?
  3. How does the specimen adequacy rate based on the AASLD criterion compare to the commonly-used criterion in EUS-LB?

Doctor’s Tip

One helpful tip a doctor might tell a patient about liver biopsy is to follow any pre-procedure instructions provided by the healthcare team, such as fasting or avoiding certain medications. This can help ensure a successful and safe biopsy procedure. Additionally, it’s important to discuss any concerns or questions with your healthcare provider before the procedure to fully understand the risks and benefits involved.

Suitable For

Patients who are typically recommended for liver biopsy include those with suspected liver parenchymal diseases or focal liver lesions. This may include patients with liver cirrhosis, hepatitis, liver tumors, or other liver abnormalities. Additionally, patients who have abnormal liver function tests, unexplained liver enzyme elevations, or suspected liver diseases may also be recommended for a liver biopsy. The decision to perform a liver biopsy is typically made by a healthcare provider based on the individual patient’s medical history, symptoms, and diagnostic test results.

Timeline

Before liver biopsy:

  • Patient may undergo blood tests, imaging studies, and consultations with a healthcare provider to determine the need for a liver biopsy
  • Patient may need to stop taking certain medications or supplements before the procedure
  • Patient may need to fast for a certain period of time before the procedure
  • Patient may receive sedation or anesthesia before the procedure
  • Patient may be positioned on their back or side during the procedure
  • Ultrasound or other imaging may be used to guide the biopsy needle to the liver
  • A small incision may be made in the skin for the biopsy needle to be inserted
  • Tissue samples are collected using the biopsy needle
  • The incision site is typically covered with a bandage after the procedure

After liver biopsy:

  • Patient may be monitored for a period of time after the procedure to ensure there are no complications
  • Patient may experience some mild pain or discomfort at the biopsy site
  • Patient may be advised to rest and avoid strenuous activities for a period of time after the procedure
  • Patient may need to follow up with their healthcare provider to discuss the results of the biopsy
  • Patient may need additional testing or treatments based on the biopsy results
  • Patient may need to monitor for signs of infection or other complications at the biopsy site
  • Patient may resume normal activities once cleared by their healthcare provider.

What to Ask Your Doctor

  1. What is the reason for recommending a liver biopsy in my case?
  2. What are the potential risks and complications associated with the liver biopsy procedure?
  3. How should I prepare for the liver biopsy procedure?
  4. Will I need to stop taking any medications before the liver biopsy?
  5. How long will the liver biopsy procedure take, and will I need to stay in the hospital afterwards?
  6. How will the biopsy sample be analyzed, and when can I expect to receive the results?
  7. Are there any specific post-procedure instructions I should follow?
  8. How often will I need to follow up with you after the liver biopsy?
  9. What are the alternative diagnostic options to a liver biopsy in my case?
  10. Are there any specific factors, such as needle type or size, that may influence the success of the liver biopsy procedure in my case?

Reference

Authors: Zeng K, Jiang Z, Yang J, Chen K, Lu Q. Journal: Scand J Gastroenterol. 2022 May;57(5):545-557. doi: 10.1080/00365521.2021.2025420. Epub 2022 Jan 20. PMID: 35049405