Our Summary

This research paper is about a new technique to take liver samples for diagnosing liver diseases. The technique is called endoscopic ultrasonography-guided liver biopsy (EUS-LB). The authors of this paper wanted to find out how accurate this method is and what factors could affect the quality of the samples taken.

To do this, they looked at previously published studies in which this technique was used, up until July 2020. They analyzed data from these studies and applied statistical methods to get overall estimates for important measures like total specimen length and complete portal tracts (these are technical terms related to the size and quality of the samples taken).

They found that, on average, the samples taken using this method were of good quality. They also found that some procedural factors can influence the quality of the samples. For example, using core biopsy needles resulted in better samples than fine-needle aspiration needles. Also, a technique called “slow-pull” resulted in better samples than using suction.

The authors concluded that EUS-LB is a good alternative to other methods of taking liver samples. They also suggested that using fine-needle biopsy needles with a slow-pull technique can provide better results. However, they noted that there were some differences between the studies they looked at, and there weren’t many randomized control trials, which are generally considered the most reliable type of study.

FAQs

  1. What is endoscopic ultrasonography-guided liver biopsy (EUS-LB) and why is it important to liver disease diagnosis?
  2. How does the type of needle used in EUS-LB affect the quality of the liver samples taken?
  3. What is the “slow-pull” technique and how does it improve the quality of the liver samples obtained through EUS-LB?

Doctor’s Tip

A helpful tip a doctor might tell a patient about liver biopsy is to follow any pre-procedure instructions carefully, such as fasting before the procedure. Additionally, patients should inform their doctor of any medications they are taking, especially blood thinners, as these may need to be adjusted prior to the biopsy. After the procedure, it is important to follow the doctor’s instructions for recovery and monitor for any signs of infection or bleeding.

Suitable For

Patients who are typically recommended for a liver biopsy include those with suspected liver diseases such as hepatitis, cirrhosis, fatty liver disease, autoimmune liver diseases, and liver cancers. Additionally, patients with abnormal liver function tests, unexplained liver enlargement, or unexplained ascites (fluid accumulation in the abdomen) may also be recommended for a liver biopsy to help diagnose the underlying cause of their symptoms. Patients with a history of alcohol abuse, known liver disease, or those who require monitoring of a known liver condition may also undergo a liver biopsy. Ultimately, the decision to recommend a liver biopsy is based on the individual patient’s medical history, symptoms, and diagnostic test results.

Timeline

Before the liver biopsy:

  • The patient undergoes a physical examination and medical history review to determine the need for a liver biopsy.
  • Blood tests may be conducted to assess liver function and check for any bleeding or clotting disorders.
  • The patient may be instructed to avoid certain medications that could affect the procedure.
  • The patient is informed about the procedure and any potential risks or complications.

During the liver biopsy:

  • The patient is positioned on their back or side, depending on the technique used.
  • Local anesthesia is administered to numb the area where the biopsy needle will be inserted.
  • The doctor uses ultrasound or other imaging techniques to guide the needle to the liver and take the tissue sample.
  • The patient may feel pressure or a brief sharp pain during the procedure.
  • The tissue sample is collected and sent to a laboratory for analysis.

After the liver biopsy:

  • The patient is monitored for a few hours to check for any complications such as bleeding or infection.
  • The patient may experience mild pain or discomfort at the biopsy site for a few days.
  • Results from the biopsy are typically available within a week and are discussed with the patient by their healthcare provider.
  • The patient may be advised to avoid strenuous activities and certain medications for a period of time after the procedure.

What to Ask Your Doctor

  1. What is the reason for recommending a liver biopsy?
  2. How will the biopsy be performed and what can I expect during the procedure?
  3. What are the risks and potential complications associated with a liver biopsy?
  4. How accurate is the endoscopic ultrasonography-guided liver biopsy (EUS-LB) technique compared to other methods?
  5. What factors could affect the quality of the samples taken during the biopsy?
  6. How long will it take to get the results of the biopsy?
  7. What will the biopsy results tell us about my liver condition and how will this information be used in my treatment plan?
  8. Are there any specific instructions I need to follow before or after the biopsy procedure?
  9. Are there any alternative methods to obtaining a liver sample that could be considered?
  10. Are there any specific concerns or questions I should discuss with my healthcare team before proceeding with the biopsy?

Reference

Authors: Baran B, Kale S, Patil P, Kannadath B, Ramireddy S, Badillo R, DaVee RT, Thosani N. Journal: Surg Endosc. 2021 Oct;35(10):5546-5557. doi: 10.1007/s00464-020-08053-x. Epub 2020 Oct 14. PMID: 33052529