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©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Mar 16, 2020; 12(3): 83-97
Published online Mar 16, 2020. doi: 10.4253/wjge.v12.i3.83
Endoscopic ultrasound guided liver biopsy: Recent evidence
Kemmian D Johnson, Passisd Laoveeravat, Eric U Yee, Abhilash Perisetti, Ragesh Babu Thandassery, Benjamin Tharian
Kemmian D Johnson, Department of Internal Medicine, Louisiana State University Health Sciences Center, New Orleans, LA 70112, United States
Passisd Laoveeravat, Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, United States
Eric U Yee, Department of Pathology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States
Abhilash Perisetti, Benjamin Tharian, Department of Internal Medicine, Division of Gastroenterology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States
Ragesh Babu Thandassery, Department of Internal Medicine, Division of Gastroenterology, Central Arkansas Veterans Health Care System, Little Rock, AR 72205, United States
Author contributions: Johnson KD, Laoveeravat P, Tharian B, Perisetti A, Thandassery RB equally contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version; Yee EU contributed to this paper with literature review, critical revision and editing, providing pathology expertise and images, and final approval of the manuscript.
Conflict-of-interest statement: Yee EU is a consultant for PathAI. No financial support.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Ragesh Babu Thandassery, MD, Assistant Professor, Department of Internal Medicine, Division of Gastroenterology, Central Arkansas Veterans Health Care System, Little Rock, AR 72205, United States. ragesh.thandassery@va.gov
Received: October 25, 2019
Peer-review started: October 25, 2019
First decision: November 5, 2019
Revised: December 26, 2019
Accepted: March 1, 2020
Article in press: March 1, 2020
Published online: March 16, 2020
Liver biopsy (LB) is an essential tool in diagnosing, evaluating and managing various diseases of the liver. As such, histopathological results are critical as they establish or aid in diagnosis, provide information on prognosis, and guide the appropriate selection of medical therapy for patients. Indications for LB include evaluation of persistent elevation of liver chemistries of unclear etiology, diagnosis of chronic liver diseases such as Wilson's disease, autoimmune hepatitis, small duct primary sclerosing cholangitis, work up of fever of unknown origin, amyloidosis and more. Traditionally, methods of acquiring liver tissue have included percutaneous LB (PCLB), transjugular LB (TJLB) or biopsy taken surgically via laparotomy or laparoscopy. However, traditional methods of LB may be inferior to newer methods. Additionally, PCLB and TJLB carry higher risks of adverse events and complications. More recently, endoscopic ultrasound guided LB (EUS-LB) has evolved as an alternative method of tissue sampling that has proven to be safe and effective, with limited adverse events. Compared to PC and TJ routes, EUS-LB may also have a greater diagnostic yield of tissue, be superior for a targeted approach of focal lesions, provide higher quality images and allow for greater patient comfort. These advantages have contributed to the increased use of EUS-LB as a technique for obtaining liver tissue. Herein, we provide a review of the recent evidence of EUS-LB for liver disease.
Core tip: Endoscopic ultrasound guided liver biopsy is a safe and effective approach to obtaining liver biopsies that may serve as an alternative to traditional methods. Our goal is to collect and review the most recent data on the advances in endoscopic ultrasound guided liver biopsies, while also weighing the advantages and disadvantages of utilizing conventional methods of liver biopsy (percutaneous liver biopsy, transjugular liver biopsy, surgical liver biopsy).
