Endoscopic ultrasound guided liver biopsy: Recent evidence

Table 1 Advantages and disadvantages of liver biopsy methods

	Percutaneous liver biopsy	Transjugular liver bipsy	Surgery	Endoscopic ultrasound guided liver biopsy
Indication	Mainstay method of liver biopsy for unexplained abnormal LFTs, assessing, staging, diagnosing liver disease	Coagulopathy; ascites; morbid obesity; failure of percutaneous liver biopsy ; thrombocytopenia	Undergoing surgery for another indication	Undergoing endoscopy for another indication
Complications	Pain; hemorrhage; peritonitis; hypotension; infection; gallbladder perforation; pneumothorax; hemothorax	Hemorrhage; pain capsule perforation; arterial aneurysms; arrhythmias	Hemorrhage, abdominal wall injury; intraperitoneal injury; anesthesia related complications	Hemorrhage; abdominal pain; infection
Advantage	Well-known procedure; cost effective; less technical skills required	Decreased risk of complications; more tolerable; useful in patients with comorbidities	Can take LB while performing another procedure	Increased tolerability; decreased recovery time; decreased complications; bi-lobar access; decreased sampling variability; View anatomical/vascular structures
Disadvantage	Increased sampling variability; less tolerable; require more passes; increased risk of complications	Limited view of liver parenchyma and vascular anatomy; increased sample fragmentation	Invasive; requires surgical specialty	Costly, if not performed along with another endoscopic procedure