scholarly journals EUS-guided fine-needle core liver biopsy with a modified one-pass, one-actuation wet suction technique comparing two types of EUS core needles

2020 ◽  
Vol 08 (07) ◽  
pp. E938-E943 ◽  
Author(s):  
Jose Nieto ◽  
Enad Dawod ◽  
Ameya Deshmukh ◽  
Eli Penn ◽  
Douglas Adler ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Liver Biopsy ◽  
Biliary Obstruction ◽  
Diagnostic Yield ◽  
Bile Leak ◽  
Specimen Length ◽  
Intact Specimen ◽  
Medical Centers ◽  
Post Procedure ◽  
Pancreatic Pathology

Abstract Background and study aims We compared the diagnostic yield and specimen adequacy in EUS-guided parenchymal biopsies between two types of EUS 19 G core needles. Patients and methods This is a retrospective study of 420 patients at two tertiary medical centers in Florida with unexplained abnormal liver associated tests were referred for EUS evaluation of biliary obstruction and pancreatic pathology. EUS-guided liver biopsy (EUS-LB) was performed at the same session after biliary obstruction was excluded. We compared intact specimen length (ISL), total specimen length (TSL), complete portal triads (CPT) and adverse events (AE). Welch’s T and Tukey tests were used for ISL, TSL and CPT. Results A total of 210 patients underwent EUS-LB using a Franseen needle, 210 patients using a fork-tip needle. Median patient age was 52 years (15.63) and 238 (56.7 %) were female. The fork-tip needle had a mean ISL of 2.7 (1.1 SD) cm, TSL of 6 cm (2.1 SD), and mean 19.5 CPT (8.5 SD) Abdominal pain occurred in 35 patients (17 %) post-procedure and was managed with supportive care. Two patients required intravenous (IV) narcotic administration. Subcapsular hematomas occurred in 1 (0.5 %) patients. The Franseen needle had a mean ISL of 3.1 cm (1.3 SD), TSL of 6.5 cm (2.6 SD), and mean of 24 CPT (8.8 SD). Abdominal pain occurred in four patients (2 %) post-procedure, which resolved in all patients after IV narcotic administration. Subcapsular hematomas occurred in 1 (0.5 %) and bile leak in 1(0.4 %) patients. Conclusions Use of the Franseen needle resulted in better liver core samples than that obtained with a fork-tip needle.

scholarly journals Extensive Investigation of Patients with Mild Elevations of Serum Amylase and/or Lipase Is ‘Low Yield’

2002 ◽  
Vol 16 (12) ◽  
pp. 849-854 ◽  
Author(s):  
Michael F Byrne ◽  
Robert M Mitchell ◽  
Helen Stiffler ◽  
Paul S Jowell ◽  
Malcolm S Branch ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Chronic Pancreatitis ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Serum Amylase ◽  
Diagnostic Yield ◽  
Extensive Investigation ◽  
Endoscopic Retrograde ◽  
Abdominal Symptoms ◽  
Upper Limit ◽  
Pancreatic Pathology

BACKGROUND: Serum amylase and lipase levels are widely used as markers of pancreatic inflammation. However, it would seem that mild elevations of amylase and lipase rarely predict significant pancreatic pathology. Pancreatic imaging tests are expensive. The gold standard, endoscopic retrograde cholangiopancreatography, carries risk of morbidity and mortality.OBJECTIVE: To determine whether extensive investigation of patients with mild, nonspecific abdominal symptoms and mild elevations of amylase and/or lipase results in a significant diagnostic yield.METHODS: Outpatient evaluations were retrospectively analyzed over 12 months. Inclusion criteria were nonspecific abdominal pain, and mild elevations (less than three times the upper limit of normal) of serum amylase or lipase, or both. Exclusion criteria included a history of chronic pancreatitis, elevation of liver tests and acute pain syndromes.RESULTS: Nineteen patients over the study period met the criteria. Of the nineteen patients, 58% had elevation of lipase alone, 21% amylase alone and 21% had elevations of both. In addition, 89.5% of the patients had nonspecific abdominal pain. After imaging with one or more of ultrasound, computed tomography, magnetic resonance cholangiopancreatography, endoscopic ultrasound and endoscopic retrograde cholangiopancreatography, small bowel follow through or hepatobiliary scanning, 78.9% patients were thought to have a normal pancreas. Of the remaining patients, 15.8% had mild or equivocal changes of chronic pancreatitis, and one patient was found to have a pancreatic tail pseudocyst. The average cost of investigation was US$2,255, taking only direct procedural costs into account. No patient was found to have malignancy.CONCLUSIONS: The majority of patients with nonspecific abdominal pain and isolated elevations of amylase and/or lipase (less than three times the upper limit of normal) had no identifiable pancreatic pathology. The diagnostic yield in patients with mild elevations of lipase alone was particularly poor. The cost effectiveness and risk-benefit ratio of extensive investigation of this group of patients warrants further study.

scholarly journals Comparison of the Diagnostic Yield of EUS Needles for Liver Biopsy: Ex Vivo Study

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Woo Jung Lee ◽  
Lance T. Uradomo ◽  
Yang Zhang ◽  
William Twaddell ◽  
Peter Darwin
Keyword(s):  
Liver Biopsy ◽  
Ex Vivo ◽  
Diagnostic Yield ◽  
Limited Data ◽  
Specimen Length ◽  
Significant Difference ◽  
Tissue Acquisition ◽  
Liver Biopsies ◽  
Ex Vivo Study ◽  
Portal Tracts

Background and Aims. EUS-guided liver biopsy is an emerging method of liver tissue acquisition which is safe and had been shown to produce excellent histological yield. There is limited data comparing the diagnostic yield of different FNA needles. We aimed to compare the diagnostic performance of four commercially available 19-gauge FNA needles. Methods. Four FNA needles and one percutaneous needle were used to perform liver biopsies on two human cadaveric livers: Cook Echotip Procore™, Olympus EZ Shot 2™, Boston Scientific Expect Slimline™, Covidien SharkCore™, and an 18-gauge percutaneous needle (TruCore™, Argon Medical Devices). Each needle obtained biopsies by three, six, and nine complete back-and-forth motions of the needle (“throw”) with a fanning technique. The combined lengths of specimen fragments and the total number of complete portal tracts (CPT) were measured by a blinded pathologist. One-way analysis of variance (ANOVA) and Bonferroni correction were used for statistical analysis. Results. A total of 52 liver biopsies were performed. The Covidien SharkCore needle had significantly greater number of CPT compared to other FNA needles. The number of “throws” did not impact the number of CPT significantly. There was no statistically significant difference in mean total specimen length between each FNA needle type. Conclusion. The Covidien SharkCore needle produced superior histological specimen by capturing more CPT, possibly due to its unique needle design.

scholarly journals Intrabiliary and abdominal rupture of hepatic hydatid cyst leading to biliary obstruction, cholangitis, pancreatitis, peritonitis and septicemia: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Manouchehr Aghajanzadeh ◽  
Mohammad Taghi Ashoobi ◽  
Hossein Hemmati ◽  
Pirooz Samidoust ◽  
Mohammad Sadegh Esmaeili Delshad ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Hydatid Cyst ◽  
Hydatid Disease ◽  
Biliary Obstruction ◽  
Abdominal Ultrasound ◽  
Sporadic Case ◽  
Gallbladder Wall ◽  
Liver Cyst ◽  
Biliary Duct ◽  
Wall Thickening

Abstract Background Hydatid cysts are fluid-filled sacs containing immature forms of parastic tapeworms of the genus Echinococcus. The most prevalent and serious complication of hydatid disease is intrabiliary rupture, also known as cystobiliary fistulae. In this study, a sporadic case of biliary obstruction, cholangitis, and septicemia is described secondary to hydatid cyst rupture into the common bile duct and intraperitoneal cavity. Case presentation A 21-year-old Iranian man was admitted to the emergency ward with 5 days of serious sickness and a history of right upper quadrant abdominal pain, fatigue, fever, icterus, vomiting, and no appetite. In the physical examination, abdominal tenderness was detected in all four quadrants and in the scleral icterus. Abdominal ultrasound revealed intrahepatic and extrahepatic biliary duct dilation. Gallbladder wall thickening was normal but was very dilated, and large unilocular intact hepatic cysts were detected in segment IV and another one segment II which had detached laminated membranes and was a ruptured or complicated liver cyst. Conclusion Intrabiliary perforation of the liver hydatid cyst is an infrequent event but has severe consequences. Therefore, when patients complain of abdominal pain, fever, peritonitis, decreased appetite, and jaundice, a differential diagnosis of hydatid disease needs to be taken into consideration. Early diagnosis of complications and aggressive treatments, such as endoscopic retrograde cholangiopancreatography and surgery, are vital.

scholarly journals Diagnostic yield and appropriate indication of upper endoscopy in Jordanian children

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eyad Altamimi ◽  
Yousef Odeh ◽  
Tuka Al-quraan ◽  
Elmi Mohamed ◽  
Naif Rawabdeh
Keyword(s):  
Abdominal Pain ◽  
Diagnostic Yield ◽  
Failure To Thrive ◽  
University Hospital ◽  
P Value ◽  
Upper Endoscopy ◽  
Detection Rates ◽  
Common Indication ◽  
Histopathological Findings ◽  
Endoscopic Findings

Abstract Background Upper endoscopy is an essential tool for diagnosing pediatric gastrointestinal issues. This study aimed to assess the indications, diagnostic yields, concordance between histopathological and endoscopic findings and suitability of upper endoscopies performed at a tertiary university hospital in Jordan. Methods Hospital records of children who underwent upper endoscopy were retrospectively reviewed. Demographics, endoscopic details (e.g., indications, findings and any complications), and histopathological findings were collected. The relationship between endoscopic findings and histopathological abnormalities was reported. Results The study included 778 patients (age, 92.5 ± 54.5 months; 380 girls, 48.8%). The most common age group was children younger than 60 months (273 patients, 34.3%). The most common indication for endoscopy was abdominal pain, followed by vomiting and failure to thrive or weight loss. Normal upper endoscopy was reported in 411 patients (52.8%). Age below 60 months, abdominal pain, dysphagia/odynophagia, and heartburn were predictive of abnormal endoscopy in multivariate analysis with p-value 0.000, 0.048, 0.001 and 0.01 respectively. Abnormal endoscopy showed 67.3% sensitivity and 69.9% specificity to predict histopathological abnormalities. Of those performed, 13.6% endoscopies were described as inappropriate indication. The suitability of the procedure was a sensitive predictor for abnormal endoscopic and histopathological findings. Conclusions Abdominal pain is the most common indication for upper endoscopy in our population. It is associated with a higher chance of abnormal endoscopy. Concordance between endoscopic and histopathological findings is not high. Normal endoscopic findings shouldn`t discourage the endoscopist from obtaining tissue biopsies. Considering more biopsies may improve pathological detection rates. Compliance with established endoscopy guidelines may reduce unnecessary procedures.

Diagnostic Yield of Transjugular Liver Biopsy Samples to Evaluate for Infectious Etiology of Liver Dysfunction in Bone Marrow Transplant Recipients

2013 ◽  
Vol 37 (2) ◽  
pp. 471-475 ◽  
Author(s):  
Gregory Nadolski ◽  
Jeffrey I. Mondschein ◽  
Richard D. Shlansky-Goldberg ◽  
S. William Stavropoulos ◽  
Michael C. Soulen ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Liver Biopsy ◽  
Bone Marrow Transplant ◽  
Liver Dysfunction ◽  
Diagnostic Yield ◽  
Marrow Transplant ◽  
Transplant Recipients ◽  
Transjugular Liver Biopsy ◽  
Infectious Etiology

Mo1400 Endoscopic Ultrasound Guided Liver Biopsy for Parenchymal Disease: a Comparison of Diagnostic Yield Between Two Needles

2014 ◽  
Vol 79 (5) ◽  
pp. AB423 ◽  
Author(s):  
Michael S. Sey ◽  
Mohammad a. AL-Haddad ◽  
Kathleen a. Mcgreevy ◽  
Thomas F. Imperiale ◽  
Jinmei Lin ◽  
...  
Keyword(s):  
Liver Biopsy ◽  
Endoscopic Ultrasound ◽  
Diagnostic Yield ◽  
Ultrasound Guided ◽  
Parenchymal Disease

Liver biopsy

2018 ◽  
Author(s):  
Lily Martin
Keyword(s):  
Liver Biopsy ◽  
Post Procedure ◽  
The Common

The chapter on liver biopsy in children includes the indications and contraindications of this procedure. It describes the various techniques used, as well as the pre- and post-procedure management and the common complications.

scholarly journals Su1326 DIAGNOSTIC YIELD OF TWO ENDOSCOPIC ULTRASOUND-GUIDED LIVER BIOPSY TECHNIQUES (“WET SALINE” AND “WET HEPARIN”) FOR PARENCHYMAL LIVER DISEASE

2020 ◽  
Vol 91 (6) ◽  
pp. AB333
Author(s):  
Hamzeh Saraireh ◽  
Thaer Abdelfattah ◽  
Puneet Puri ◽  
Robert Lippman ◽  
Pritesh R. Mutha ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Biopsy ◽  
Endoscopic Ultrasound ◽  
Diagnostic Yield ◽  
Ultrasound Guided ◽  
Parenchymal Liver
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