Rucha M Shah1, Jason Schmidt2, Elizabeth John1, Sheila Rastegari3, Priyanka Acharya4, Prashant Kedia1,5. 1. Department of Gastroenterology, Methodist Dallas Medical Center, Dallas, TX, USA. 2. Department of Pathology, Methodist Dallas Medical Center, Dallas, TX, USA. 3. Department of Internal Medicine, Methodist Dallas Medical Center, Dallas, TX, USA. 4. Methodist Health System Clinical Research Institute, Methodist Dallas Medical Center, Dallas, TX, USA. 5. Digestive Health Associates of Texas, Dallas, TX, USA.
Abstract
Background/Aims: Endoscopic ultrasound-guided liver biopsy (EUS-LB) is an effective and safe method of procuring liver tissue. The aims of this study were to assess and compare the outcomes and tissue adequacy of a single-pass, single-actuation, wet suction technique between 19 G and 22 G needles in patients undergoing EUS-LB. Methods: We performed a prospective case series study of 20 patients undergoing EUS-LB at a single center between September 2017 and April 2020. The primary objective was to evaluate differences in sample adequacy via a single actuation wet suction technique between a 19 G core needle and a 22 G core needle. Adequacy was gauged by cumulative core biopsy length and the number of portal tracts visualized. Results: The 19 G needle provided a longer core length (2.5 cm vs. 1.2 cm, p<0.0001), more complete portal tracts (5.8 vs. 1.7, p<0.0001), more total tracts (8.8 vs. 3, p<0.0001), and a longer, intact, fragment length (0.75 cm vs. 0.32 cm, p<0.0006). The 19 G needle was superior in providing adequate (60% vs. 5%, p<0.001) and diagnostic pathologic samples (85% vs. 10%, p<0.001). Conclusions: A single-pass, single-actuation, wet suction technique using a 19 G needle is superior to that using a 22 G needle for tissue acquisition and sample adequacy in EUS-LB.
Background/Aims: Endoscopic ultrasound-guided liver biopsy (EUS-LB) is an effective and safe method of procuring liver tissue. The aims of this study were to assess and compare the outcomes and tissue adequacy of a single-pass, single-actuation, wet suction technique between 19 G and 22 G needles in patients undergoing EUS-LB. Methods: We performed a prospective case series study of 20 patients undergoing EUS-LB at a single center between September 2017 and April 2020. The primary objective was to evaluate differences in sample adequacy via a single actuation wet suction technique between a 19 G core needle and a 22 G core needle. Adequacy was gauged by cumulative core biopsy length and the number of portal tracts visualized. Results: The 19 G needle provided a longer core length (2.5 cm vs. 1.2 cm, p<0.0001), more complete portal tracts (5.8 vs. 1.7, p<0.0001), more total tracts (8.8 vs. 3, p<0.0001), and a longer, intact, fragment length (0.75 cm vs. 0.32 cm, p<0.0006). The 19 G needle was superior in providing adequate (60% vs. 5%, p<0.001) and diagnostic pathologic samples (85% vs. 10%, p<0.001). Conclusions: A single-pass, single-actuation, wet suction technique using a 19 G needle is superior to that using a 22 G needle for tissue acquisition and sample adequacy in EUS-LB.
Entities:
Keywords:
19 G FNB; Endoscopic ultrasound-guided liver biopsy; Liver biopsy
Authors: Shiva Rangwani; Devarshi R Ardeshna; Khalid Mumtaz; Sean G Kelly; Samuel Y Han; Somashekar G Krishna Journal: World J Gastroenterol Date: 2022-07-28 Impact factor: 5.374