Year 2022 / Volume 114 / Number 10
Original
EUS-guided fine-needle liver biopsy in pediatric patients using a modified technique with one-pass, one-actuation wet suction

575-579

DOI: 10.17235/reed.2022.8503/2021

Javier Tejedor-Tejada, José Nieto, Ameya Deshmukh, Ahmed Mohammed Elmeligui,

Abstract
Background and aims: Liver biopsy (LB) can be a valuable tool to determine the etiology of pediatric liver disease. There is limited data of the role of EUS-LB in children. This study evaluated the efficacy and the safety of a modified technique (M)LB in cases at high risk of bleeding or obese children. In addition, the tissue yield of EUS-(M)LB and percutaneous (PC) approach were compared. Methods: A retrospective analysis was performed, comparing EUS-(M)LB and PC-LB in children at a tertiary referral center. All consecutive children referred for PC-LB and EUS-LB who had an unexplained liver test abnormality after exclusion of biliary disorders from March-2017 to August-2018 were included. EUS-(M)LB consisted of a one pass wet suction technique using a 19-gauche core needle. A comparison was performed between total specimen length (TSL) and the number of complete portal triads (CPTs). Results: The cohort included 28 EUS-(M)LB and 28 PC-LB pediatric cases. The median (IQR) age was 14.5 years (13.4-16). The median TSL was 8.6 (5.8-9.6) in EUS-(M)LB cases and 7 cm (7-9) in PC-LB cases (P =0.788). The maximum intact specimen was 2.8 cm (EUS-(M)LB) and 1.6 cm (PC-LB) (P =0.009). The mean (SD) number of CPTs per sample was 28.2 (7.3) and 11.6 (2.1), respectively (P =0.001). Adverse events included once case of self-limited abdominal pain in the PC-LB group. Conclusion: EUS-(M)LB has the potential to be a safe and effective alternative diagnostic modality when compared to PC-LB, to evaluate children with unexplained liver test abnormalities who undergo EUS to evaluate biliary disorders.
Share Button
New comment
Comments
No comments for this article
References
1- Al Knawy B, Shiffman M. Percutaneous liver biopsy in clinical practice. Liver Int. 2007;27(9):1166-1173. Doi:10.1111/j.1478-3231.2007.01592.x
Lucero C, Brown RS Jr. Noninvasive Measures of Liver Fibrosis and Severity of Liver Disease. Gastroenterol Hepatol (N Y). 2016 Jan;12(1):33-40. PMID: 27330502; PMCID: PMC4865784.
3- American Association for the Study of Liver Diseases; Rockey DC, Caldwell SH, Goodman ZD, et al. Liver biopsy. Hepatology 2009;49:1017-44.
4- Hashimoto R, Chang KJ. Endoscopic ultrasound guided hepatic interventions [published online ahead of print, 2020 Mar 7]. Dig Endosc. 2020;10.1111/den.13661. Doi:10.1111/den.13661
5- Campos S, Poley JW, van Driel L et al. The role of EUS in diagnosis and treatment of liver disorders. Endosc Int Open. 2019;7(10):E1262-E1275. Doi:10.1055/a-0958-2183
6- Samarasena J, Chang KJ. Endo-hepatology: A new paradigm. Endosc Ultrasound. 2018 Jul-Aug; 7(4): 219–222. Doi: 10.4103/eus.eus_30_18
7- Pineda JJ, Diehl DL, Miao CL et al. EUS-guided liver biopsy provides diagnostic samples comparable with those via the percutaneous or transjugular route. Gastrointest Endosc. 2016;83(2):360-365. Doi:10.1016/j.gie.2015.08.025
8- Mogahed EA, Mansy YA, Al Hawi Y et al. Blind percutaneous liver biopsy in infants and children: Comparison of safety and efficacy of percussion technique and ultrasound assisted technique. Arab J Gastroenterol. 2016;17(4):168-175. doi:10.1016/j.ajg.2016.10.001
9- Chapin CA, Mohammad S, Bass LM et al. Liver Biopsy Can Be Safely Performed in Pediatric Acute Liver Failure to Aid in Diagnosis and Management. J Pediatr Gastroenterol Nutr. 2018;67(4):441-445. Doi:10.1097/MPG.0000000000002096.
10- Dezsőfi A, Knisely AS. Liver biopsy in children 2014: who, whom, what, when, where, why?. Clin Res Hepatol Gastroenterol. 2014;38(4):395-398. Doi:10.1016/j.clinre.2014.05.002.
11- Nieto J, Khaleel H, Challita Y et al. EUS-guided fine-needle core liver biopsy sampling using a novel 19-gauge needle with modified 1-pass, 1 actuation wet suction technique. Gastrointest Endosc. 2018;87(2):469-475. Doi:10.1016/j.gie.2017.05.013.
12- Nieto J, Dawod E, Deshmukh A et al. EUS-guided fine-needle core liver biopsy with a modified one-pass, one-actuation wet suction technique comparing two types of EUS core needles. Endosc Int Open. 2020;8(7):E938-E943. Doi:10.1055/a-1165-1767.
13- Al Knawy B, Shiffman M. Percutaneous liver biopsy in clinical practice: Percutaneous liver biopsy. Liver Int. 2007, 27(9), 1166-1173.
14- Schiano T, Azeem S, Bodian C et al. Importance of Specimen Size in Accurate Needle Liver Biopsy Evaluation of Patients With Chronic Hepatitis C. Clin Gastroenterol Hepatol. 2005, 3(9), 930-935.
15- Stavropoulos SN, Im, GY, Jlayer Z et al. High yield of same-session EUS-guided liver biopsy by 19-gauge FNA needle in patients undergoing EUS to exclude biliary obstruction. Gastrointest Endosc. 2012, 75(2), 310-318.
16- Diehl DL, Johal AS, Khara HS et al. Endoscopic ultrasound-guided liver biopsy: a multicenter experience. Endosc Int Open. 2015, 3(3), E210–E215.
17- Shiha G, Sarin SK, Ibrahim AE et. al. Liver fibrosis: consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL). Hepatol Int 2009;3:323-333.
18- EASL-ALEH. Clinical Practice Guidelines: Non-invasive tests for evaluation of liver disease severity and prognosis. http://www.easl.eu/medias/cpg/Non-invasive/English-report.pdf. Accessed 16 August 2020.
19- Gor N, Salem SB, Jakate S et al. Histological adequacy of EUS-guided liver biopsy when using a 19-gauge non-Tru-Cut FNA needle. Gastrointest Endosc. 2014;79(1):170-172.
20- Gleeson FC, Clayton AC, Zhang L, et al. Adequacy of endoscopic ultrasound core needle biopsy specimen of nonmalignant hepatic parenchymal disease. Clin Gastroenterol Hepatol 2008;6:1437-40.
Related articles

Letter

Gastric schwannoma diagnosing gastric stromal tumor

DOI: 10.17235/reed.2023.9919/2023

Letter

Blue rubber bleb nevus syndrome

DOI: 10.17235/reed.2023.9913/2023

Letter

Capsule endoscopy diagnosis of gastrointestinal melanoma

DOI: 10.17235/reed.2023.9803/2023

Letter

Calcifying fibrous tumor and pathological analysis

DOI: 10.17235/reed.2023.9739/2023

Letter

Endoscopic observation of a rare duodenal tumor

DOI: 10.17235/reed.2023.9679/2023

Letter

Endoscopic rescue of a fistulizing biliary plastic stent

DOI: 10.17235/reed.2023.9673/2023

Editorial

Recent advances in the diagnosis and management of Wilson’s disease

DOI: 10.17235/reed.2023.9633/2023

Letter

MALT lymphoma of the colon: an endoscopic challenge

DOI: 10.17235/reed.2023.9595/2023

Letter

Sigmoid volvulus management, only endoscopic devolvulation?

DOI: 10.17235/reed.2023.9488/2023

Letter

Isolated Jejunal Crohn's Disease: a challenging diagnosis

DOI: 10.17235/reed.2022.9423/2022

Letter

New technique for the endoscopic removal of long foreign bodies

DOI: 10.17235/reed.2023.9398/2022

Digestive Diseases Image

Whipple’s disease – A typical endoscopic finding of a rare disease

DOI: 10.17235/reed.2022.9338/2022

Letter

Vaginal lesion as first manifestation of colorectal disease

DOI: 10.17235/reed.2022.9270/2022

Letter

Budd-Chiari syndrome in Behçet’s disease

DOI: 10.17235/reed.2022.9267/2022

Digestive Diseases Image

A rare endoscopic pattern in a patient with gastroesophageal reflux disease

DOI: 10.17235/reed.2022.9124/2022

Digestive Diseases Image

Esophageal tuberculosis

DOI: 10.17235/reed.2022.9108/2022

Digestive Diseases Image

Esophagopleural fistula due to empyema necessitans

DOI: 10.17235/reed.2022.9085/2022

Digestive Diseases Image

Pneumatosis intestinalis: a rare endoscopic feature of colonic ischemia

DOI: 10.17235/reed.2022.8980/2022

Letter

Primary intestinal melanoma?

DOI: 10.17235/reed.2022.8944/2022

Letter

Intestinal amyloidosis: a diagnostic challenge

DOI: 10.17235/reed.2022.8934/2022

Letter

Successful gallstone ileus treatment by endoscopy

DOI: 10.17235/reed.2022.8898/2022

Letter

Digestive tract MALT lymphoma, an unusual location

DOI: 10.17235/reed.2022.8800/2022

Digestive Diseases Image

An unusual cause of a protuberant lesion of the gastric antrum

DOI: 10.17235/reed.2022.8771/2022

Digestive Diseases Image

Esophageal epidermoid metaplasia: an unusual condition

DOI: 10.17235/reed.2022.8708/2022

Letter

Sigmoid colon Schwannoma simulating colon cancer

DOI: 10.17235/reed.2022.8684/2022

Digestive Diseases Image

Ileal neuroendocrine tumor as an uncommon cause of obscure gastrointestinal bleeding

DOI: 10.17235/reed.2022.8641/2022

Digestive Diseases Image

A case of duodenal-type follicular lymphoma

DOI: 10.17235/reed.2021.8233/2021

Digestive Diseases Image

Endoscopic resection of a duodenal neuroendocrine tumor

DOI: 10.17235/reed.2021.8232/2021

Letter

Unexpected diagnosis for nodular hepatic lesions

DOI: 10.17235/reed.2021.8230/2021

Digestive Diseases Image

Duodenal-type follicular lymphoma: a silent tumor

DOI: 10.17235/reed.2021.8149/2021

Digestive Diseases Image

Abdominal cocoon sign: an unusual cause of intestinal obstruction

DOI: 10.17235/reed.2021.8057/2021

Digestive Diseases Image

Primary or idiopathic intestinal pneumatosis: a rare casual endoscopic finding

DOI: 10.17235/reed.2021.8049/2021

Letter

POEMS syndrome: an uncommon cause of peritoneal effusion

DOI: 10.17235/reed.2021.8027/2021

Letter

Bochdalek hernia: use of capsule endoscopy

DOI: 10.17235/reed.2021.7760/2020

Digestive Diseases Image

Endoscopic forceps removal for complicated magnetic beads impaction

DOI: 10.17235/reed.2021.7731/2020

Letter

Mucinous cystadenoma arising from a pancreatic heterotopia

DOI: 10.17235/reed.2020.7486/2020

Digestive Diseases Image

Esophageal involvement in a patient with pemphigus vulgaris

DOI: 10.17235/reed.2020.7417/2020

Letter

Basic training in gastrointestinal endoscopy: recording images

DOI: 10.17235/reed.2020.7385/2020

Digestive Diseases Image

Phlebosclerotic colitis: an unusual cause of abdominal pain and hematochezia

DOI: 10.17235/reed.2020.7358/2020

Review

New non-invasive biomarkers for colorectal cancer screening

DOI: 10.17235/reed.2020.7233/2020

Editorial

Reflex testing. A key tool for the elimination of hepatitis C

DOI: 10.17235/reed.2020.7201/2020

Letter

Chilaiditi’s and Ogilvie syndromes

DOI: 10.17235/reed.2020.7036/2020

Review

Advanced therapy by device-assisted enteroscopy

DOI: 10.17235/reed.2020.6971/2020

Letter

Luetic gastritis: an uncommon cause of gastritis

DOI: 10.17235/reed.2020.6870/2020

Letter

Hepatocarcinoma diagnosis. Reflection is required

DOI: 10.17235/reed.2020.6845/2019

Letter

Gastric ulcer due to mucormycosis in a critical patient

DOI: 10.17235/reed.2020.6636/2019

Letter

Primary gastric choriocarcinoma

DOI: 10.17235/reed.2020.6478/2019

Digestive Diseases Image

Jejunal schwannoma detected by video capsule endoscopy

DOI: 10.17235/reed.2020.6474/2019

Digestive Diseases Image

Capsule endoscopy, a useful tool for the diagnosis of a tapeworm infection

DOI: 10.17235/reed.2019.6346/2019

Editorial

Endoscopy units – Statu quo

DOI: 10.17235/reed.2019.6347/2019

Letter

Endoscopically diagnosed systemic mastocytosis

DOI: 10.17235/reed.2019.6246/2019

Digestive Diseases Image

A rare heterotopic gastric mucosa appearing between the muscularis mucosae and submucosa

DOI: 10.17235/reed.2019.6134/2018

Special Article

Quality indicators in gastroscopy. Gastroscopy procedure

DOI: 10.17235/reed.2019.6023/2018

Letter

Endoscopic management of Boerhaave’s syndrome

DOI: 10.17235/reed.2019.6013/2018

Digestive Diseases Image

Intraductal papillary mucinous neoplasm of the main duct in a patient with pancreas divisum

DOI: 10.17235/reed.2019.5959/2018

Letter

Use of patency capsule in daily practice

DOI: 10.17235/reed.2019.5952/2018

Letter

Symptomatic exfoliative esophagitis induced by dabigatran

DOI: 10.17235/reed.2018.5747/2018

Special Article

The current situation of digestive endoscopy units in the Valencian Community

DOI: 10.17235/reed.2019.5676/2018

Special Article

Endoscopy and sedation: an inseparable binomial for the gastroenterologist

DOI: 10.17235/reed.2018.5585/2018

Digestive Diseases Image

Dysphagia and hematemesis caused by an intramural esophageal dissection

DOI: 10.17235/reed.2018.5471/2018

Letter to the Editor

GETTEMO position statement on bariatric endoscopic techniques as a voluntary medicine

DOI: 10.17235/reed.2017.5144/2017

Letter to the Editor

Sternal cutaneous metastasis of hilar cholangiocarcinoma

DOI: 10.17235/reed.2017.4979/2017

Digestive Diseases Image

Metastasis of dermatofibrosarcoma diagnosed by capsule endoscopy

DOI: 10.17235/reed.2018.4900/2017

Letter to the Editor

Pancreatic neuroendocrine tumors

DOI: 10.17235/reed.2017.4725/2016

Letter to the Editor

Symptomatic retention of the Agile® patency capsule

DOI: 10.17235/reed.2017.4691/2016

Letter to the Editor

Ball valve syndrome caused by a giant gastric Vanek’s tumor

DOI: 10.17235/reed.2017.4526/2016

Original

Multicenter study on the safety of bariatric endoscopy

DOI: 10.17235/reed.2017.4499/2016

Letter to the Editor

Endoscopic removal of a hashish packet

DOI: 10.17235/reed.2017.4504/2016

Original

3D echoendoscopy and miniprobes for rectal cancer staging

DOI: 10.17235/reed.2018.4453/2016

Letter to the Editor

Whipple’s disease under the vision of capsule endoscopy

DOI: 10.17235/reed.2016.4362/2016

Letter to the Editor

Asymptomatic bronchial aspiration of capsule endoscope: a significant complication

DOI: 10.17235/reed.2016.4363/2016

Letter to the Editor

Author´s reply: About human taeniasis and Taenia saginata diagnosis by endoscopy

DOI: 10.17235/reed.2016.4339/2016

Letter to the Editor

About human taeniasis and Taenia saginata diagnosis by endoscopy

DOI: 10.17235/reed.2016.4297/2016

Letter to the Editor

Transanal submucosal endoscopic resection (TASER) by TEO system®

DOI: 10.17235/reed.2016.4154/2015

Case Report

Glycogenic hepatopathy in young adults: a case series

DOI: 10.17235/reed.2016.3934/2015

Case Report

Atypical diagnosis diagnosis by endoscopic capsule: Whipple´s disease

DOI: 10.17235/reed.2015.3718/2015

Citation tools
Tejedor-Tejada J, Nieto J, Deshmukh A, Elmeligui A. EUS-guided fine-needle liver biopsy in pediatric patients using a modified technique with one-pass, one-actuation wet suction . 8503/2021


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 1525 visits.
This article has been downloaded 104 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 07/12/2021

Accepted: 15/01/2022

Online First: 18/01/2022

Published: 07/10/2022

Article revision time: 33 days

Article Online First time: 42 days

Article editing time: 304 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology