Ultrasound-guided liver biopsy for parenchymal liver disease. An economic analysis

Abstract Background: Endoscopic ultrasound-guided liver biopsy (EUS-LB) has emerged as a viable mean to obtain core tissue. Different wet suction techniques using saline or heparin have been described. We aimed to compare tissue adequacy with the “wet saline” (WS) technique compared to the “wet heparin” (WH) technique.Methods: We conducted a retrospective review of patients who underwent EUS-LB and Percutaneous liver biopsy (PLB-LB) for benign parenchymal liver disease between May 2017 to October 2019. All procedures were performed at a single tertiary Veterans Affairs Medical Center (VAMC).Results: A total of 257 biopsies from 217 patients were included. Among the 102 EUS-LB specimens, 53 were obtained using WS technique and 49 were obtained using WH technique. Specimen adequacy was similar in the both groups. Median ASL and length of longest piece did not differ significantly between both groups. Clots were present more frequently in the WS group. Among patients who underwent EUS-LB of both right and left liver lobes, an adequate biopsy was obtained in 85% of patients in the WS group and 96% of patients in the WH group. EUS-LB showed lower risk of post procedural pain and complication rates when compared with percutaneous liver biopsy (PLB). To our knowledge, this is the first study to compare diagnostic accuracy between WH and WS EUS-LB techniques, and to compare post-procedure pain between EUS-LB and moderate sedation PLB. WH-EUS-LB may be preferable to WS because of fewer clots in the specimen. Prospective studies are needed to further verify these findings.

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A Rare Cause of Chronic Liver Disease Diagnosed by Endoscopic Ultrasound-Guided Liver Biopsy

American Journal of Case Reports ◽

10.12659/ajcr.933002 ◽

2021 ◽

Vol 22 ◽

Author(s):

Nourah A. Alajeel ◽

Mohammad Shehab ◽

Issam Francis ◽

Ali Alali

Keyword(s):

Liver Disease ◽

Liver Biopsy ◽

Chronic Liver Disease ◽

Endoscopic Ultrasound ◽

Chronic Liver ◽

Ultrasound Guided

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Association between Administration of Antithrombotics and Intraperitoneal Hemorrhage in Patients Undergoing Percutaneous Interventions for Liver Diseases

Journal of Clinical Medicine ◽

10.3390/jcm10112527 ◽

2021 ◽

Vol 10 (11) ◽

pp. 2527

Author(s):

Akira Asai ◽

Keisuke Yokohama ◽

Hideko Ohama ◽

Yusuke Tsuchimoto ◽

Shinya Fukunishi ◽

...

Keyword(s):

Risk Factor ◽

Liver Disease ◽

Liver Biopsy ◽

Liver Diseases ◽

Retrospective Cohort ◽

American Association ◽

Ultrasound Guided ◽

Percutaneous Interventions ◽

Intraperitoneal Hemorrhage ◽

Number Of Patients

Currently, percutaneous interventions are essential for diagnosis and treatment of liver diseases. The most frequent complication of percutaneous interventions is intraperitoneal hemorrhage. Recently, the number of patients with liver diseases on antithrombotics has been increasing. This retrospective cohort study aimed to evaluate the risk factors for intraperitoneal hemorrhage in patients after percutaneous interventions for liver diseases. This study included 1025 patients who underwent percutaneous interventions for liver diseases from April 2015 to March 2020. All interventions were performed using an ultrasound-guided approach. The influence of antithrombotic drug administration in patients, who underwent percutaneous interventions according to the guidelines for the American Association for the Study of Liver Disease, was evaluated. Intraperitoneal hemorrhage after percutaneous interventions was detected by computed tomography. Intraperitoneal hemorrhage occurred in nine patients (0.88%); however, these adverse events were not severe. We compared clinical characteristics between the patients with and without intraperitoneal hemorrhage. Although, there was no difference based on the administration of antithrombotics (p = 0.1961), seven of nine patients who showed intraperitoneal hemorrhage received percutaneous treatments (radio frequency ablation or microwave ablation). Therefore, we divided patients who underwent treatments and liver biopsy and then investigated the influence of antithrombotics on the intraperitoneal hemorrhage. After propensity score matching in each patient group, the administration of antithrombotics was not identified as a risk factor for hemorrhage in patients who underwent interventional treatments and patients who underwent liver biopsy. When the antithrombotics were discontinued, according to the guidelines, it may not increase the risk factor for hemorrhage in patients of liver disease who underwent percutaneous interventions.

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