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Endoscopic Ultrasound-Guided, Percutaneous, and Transjugular Liver Biopsy: A Comparative Systematic Review and Meta-Analysis

Clinical Endoscopy 2020년 53권 5호 p.583 ~ 593
McCarty Thomas R., Bazarbashi Ahmad Najdat, Njei Basile, Ryou Marvin, Aslanian Harry R., Muniraj Thiruvengadam,
소속 상세정보
 ( McCarty Thomas R. ) - Brigham and Women’s Hospital Division of Gastroenterology, Hepatology and Endoscopy
 ( Bazarbashi Ahmad Najdat ) - Brigham and Women’s Hospital Division of Gastroenterology, Hepatology and Endoscopy
 ( Njei Basile ) - Yale University School of Medicine Section of Digestive Diseases
 ( Ryou Marvin ) - Brigham and Women’s Hospital Division of Gastroenterology, Hepatology and Endoscopy
 ( Aslanian Harry R. ) - Yale University School of Medicine Section of Digestive Diseases
 ( Muniraj Thiruvengadam ) - Yale University School of Medicine Section of Digestive Diseases

Abstract


Background/Aims: Percutaneous liver biopsy (PCLB) or transjugular liver biopsy (TJLB) have traditionally been performed to obtain a sample of hepatic tissue; however, endoscopic ultrasound-guided liver biopsy (EUSLB) has become an attractive alternative. The aim of this study was to compare the efficacy and safety of EUSLB, PCLB, and TJLB.

Methods: Search strategies were developed in accordance with PRISMA and MOOSE guidelines. Major outcomes included the following: adequacy of biopsy specimens (i.e., complete portal triads [CPT], total specimen length [TSL] in mm, and length of longest piece [LLP]) in mm), and rate of adverse events. Only studies comparing all biopsy approaches (i.e., EUSLB, PCLB, and TJLB) were included.

Results: Five studies (EUSLB [n=301]; PCLB [n=176]; and TJLB [n=179]) were included. Biopsy cumulative adequacy rates for EUSLB, PCLB, and TJLB were 93.51%, 98.27%, and 97.61%, respectively. Based on the subgroup analysis limited to EUS biopsy needles in current clinical practice, there was no difference in biopsy adequacy or adverse events for EUSLB compared to PCLB and TJLB (all p>0.050). A comparison of EUSLB and PCLB revealed no difference between specimens regarding both CPT (p=0.079) and LLP (p=0.085); however, a longer TSL (p<0.001) was observed. Compared to TJLB, EUSLB showed no difference in LLP (p=0.351), fewer CPT (p=0.042), and longer TSL (p=0.005).

Conclusions: EUSLB appears to be a safe, minimally invasive procedure that is comparable to PCLB and TJLB regarding biopsy specimens obtained and rate of adverse events associated with each method.

키워드

Endoscopic ultrasound (EUS); Interventional endoscopy; Liver biopsy

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