title: EUS-guided liver biopsy provides diagnostic samples comparable with those via the percutaneous or transjugular route.
abstract: OBJECTIVE
  Liver biopsy (LB) traditionally has been performed via a percutaneous (PC), transjugular (TJ), or surgical approach. EUS-guided LB (EUS-LB) is an emerging method that has shown promise in terms of tissue yield and procedural safety. Comparison of histologic yield of EUS-LB with other methods of LB has not been done. This study aimed to compare tissue yield of different LB methods.
  
  
  METHODS
  EUS-LB, TJ-LB, and PC-LB were identified retrospectively. EUS-LB was obtained via transgastric and transduodenal biopsy, or via transgastric (left lobe) biopsy alone using a 19-gauge FNA needle (non-Trucut). TJ-LB specimens were obtained with an 18- or 19-gauge needle, and PC-LB specimens with an 18- or 20-gauge needle. Stained slides were digitized on a whole slide scanner, and the total specimen length (TSL) and the count of complete portal triads (CPTs) were determined. Comparisons of TSL and CPT among the 3 groups were done with Wilcoxon rank sum tests.
  
  
  RESULTS
  Wilcoxon rank sum tests indicated that EUS-LB of both liver regions produced significantly more tissue in terms of both TSL and CPTs compared with a PC-LB (P = .0000 and .0006). EUS-LB produced significantly longer TSL than TJ-LB (P = .01) and similar CPTs (P = .22). Those EUS-LB cases in which the left lobe only was sampled were not statistically different compared with PC-LB and TJ-LB.
  
  
  CONCLUSIONS
  EUS-guided-LB produces specimens at least comparable to, and in some cases better than, PC-LB or TJ-LB. Widely separated liver regions can be easily sampled, which may have some benefit. The role of EUS-LB is likely to increase in the future.
authors: Department of Gastroenterology and Nutrition, Geisinger Medical Center, Danville, Pennsylvania, USA.
authors: Jonh J
authors: JJ
authors: Pineda
authors: Department of Gastroenterology and Nutrition, Geisinger Medical Center, Danville, Pennsylvania, USA.
authors: David L
authors: DL
authors: Diehl
authors: Department of Gastroenterology and Nutrition, Geisinger Medical Center, Danville, Pennsylvania, USA.
authors: Chuan L
authors: CL
authors: Miao
authors: Department of Gastroenterology and Nutrition, Geisinger Medical Center, Danville, Pennsylvania, USA.
authors: Amitpal S
authors: AS
authors: Johal
authors: Department of Gastroenterology and Nutrition, Geisinger Medical Center, Danville, Pennsylvania, USA.
authors: Harshit S
authors: HS
authors: Khara
authors: Department of Interventional Radiology, Geisinger Medical Center, Danville, Pennsylvania, USA.
authors: Ashok
authors: A
authors: Bhanushali
authors: Department of Pathology, Geisinger Medical Center, Danville, Pennsylvania, USA.
authors: Eric Z
authors: EZ
authors: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology*; D008107:Liver Diseases / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D055815:Young Adult