Endoscopic ultrasound guided liver biopsy: Recent evidence

Table 2 Comprehensive review of studies on endoscopic ultrasound guided liver biopsy

Ref.	Study design	n	Indication	Needle used	No of passes	CPTs	TSL	Insufficient sample	Adverse events
Wiersema et al[70], 2002	Prospective cohort	9	No medical indication	19G Tru-cut	NR	1	4 mm	0	None
Gleeson et al[54], 2008	Retrospective case series	9	Hepatic parenchymal disease	19G Tru-cut	2	7	16.9 mm	0	None
DeWitt et al[71], 2009	Prospective case series	21	Hepatic parenchymal disease	19G Tru-cut	3	2	9 mm	10%	None
Stavropoulos et al[55], 2012	Prospective case series	22	Abnormal LFTs	19G FNA (non-Tru-cut)	2	9	36.9 mm	9%	None
Gor et al[73], 2014	Prospective case series	10	Abnormal LFTs; Suspected cirrhosis	19G FNA (non-Tru-cut)	3	9.2	14.4 mm	0	None
Diehl et al[51], 2015	Retrospective cohort	110	Persistent transaminitis	19G FNA Expect Flexible	1 to 2	14	38 mm	2%	Self-limited bleeding
Lee et al[67], 2015	Prospective cohort	21	Rescue for PCLB	22G FNB, 25G FNB	2	NR	NR	9.50%	None
Pineda et al[66], 2016	Retrospective cohort	110	Abnormal LFTs of Unknown Etiology	19G FNA Expect/Flexible	3	14	38 mm	2%	NR
Sey et al[72], 2016	Prospective Cross-sectional	75	Suspected parenchymal disease	19G FNB ProCore; 19G FNB Tru-Cut	2; 3	5; 2	20 mm; 9 mm	3%; 27%	None; Pain
Schulman et al[79], 2017	Prospective ex-vivo	48	No medical indication	18G1 (percutaneous); 18G2 (percutaneous); 19G FNA Expect; 19G FNB ProCore; 19G FNB SharkCore; 22G FNB SharkCore	1 to 2	2.5; 3.5; 1.9; 1.7; 6.2; 3.8	NR; NR; NR; NR; NR; NR	16.7%; 18.7%; 54%; 81%; 14.6%; 14.6%	None
Mok et al[53], 2017	Prospective cross-over	20	Elevated LFT Unknown Etiology	19G FNB; 22G FNB SharkCore	NR	7.4; 6.1	76.5 mm; 66.9 mm	2.5%; 2.5%	None; Pain
Shah et al[75], 2017	Retrospective chart review	24	Abnormal LFTs, pancreaticobiliary disease	19G FNB SharkCore	2	32.5	65.6 mm	4%	Pain; Subcapsular bleeding
Saab et al[87], 2017	Retrospective chart review	47	Biliary tract disease, abnormal LFTs	19G FNB SharkCore	NR	18	65 mm	0	Self-limited liver; hematomas
Ching-Companioni et al[83], 2018	Prospective randomized	40	Abnormal LFTs	19G FNA Expect Flexible; 19G FNB Acquire	1; 1	38; 16.5	11.8 mm; 16.3 mm	0	Pain
Nieto et al[76], 2018	Prospective observational	165	Unexplained abnormal LFTs, biliary obstruction	19G FNB SharkCore	1	18	60 mm	0	Abdominal pain; Self-limited hematoma
Mok et al[80], 2018	Prospective cross-over	40	Parenchymal liver disease	19G FNA Expect Flexible; 19G FNA Expect Flexible; 19G FNA Expect Flexible	3	4; 4; 7	23.9 mm; 29.7 mm; 49.2 mm	20%; 7%; 2%	Postprocedural bleeding
Rombaoa et al[69], 2018	Retrospective chart review	8	Unexplained abnormal LFTs, hepatitis B staging, cirrhosis	19G FNB Acquire	2	9.4	NR	NR	None
Shuja et al[68], 2019	Retrospective observational cohort	69	NASH fibrosis staging	19G FNA Expect Flexible	3	10.84	45.8 mm	NR	None
Hasan et al[77], 2019	Prospective nonrandomized trial	40	Elevated liver enzymes	22G FNB Acquire	2 L; 1 R	42	55 mm	0	Self-limiting abdominal pain
Bazerbachi et al[78], 2019	Prospective cohort	41	NAFLD diagnosis, staging	22G FNB Fork-tip	2	26	24 mm	0	Postprocedural pain

FNB: Fine needle biopsy; FNA; Fine needle aspiration; TSL; Total Specimen length; CPT: Complete portal tracts; n: Number of study participants; NAFLD: Non-alcoholic fatty liver disease; NASH: Nonalcoholic steatohepatitis.