EUS-guided fine-needle liver biopsy in pediatric patients using a modified technique with one-pass, one-actuation wet suction

• Javier Tejedor-Tejada ^[1] ; José Nieto ^[3] ; Ameya Deshmukh ^[4] ; Ahmed Mohammed Elmeligui ^[2]
  1. [1] Hospital Universitario Pío del Río Hortega

     Hospital Universitario Pío del Río Hortega

     Valladolid, España

     
  2. [2] Cairo University

     Cairo University

     Egipto

     
  3. [3] Borland Groover Clinic. Jacksonville, Florida. USA
  4. [4] Midwestern University-CCOM. Downers Grove, Illinois. USA

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• Localización: Revista Española de Enfermedades Digestivas, ISSN-e 2340-4167, ISSN 1130-0108, Vol. 114, Nº. 10, 2022, págs. 575-579
• Idioma: inglés
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• Resumen

  • 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.