Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Apr 27, 2019; 11(4): 335-343
Published online Apr 27, 2019. doi: 10.4254/wjh.v11.i4.335
Endoscopic ultrasound guided liver biopsy for parenchymal liver disease
Aun Raza Shah, Muhannad Al-Hanayneh, Monica Chowdhry, Mohammad Bilal, Shailendra Singh
Aun Raza Shah, Department of Internal Medicine, MetroHealth Medical Center, Cleveland, OH 44109, United States
Muhannad Al-Hanayneh, Mohammad Bilal, Division of Gastroenterology and Hepatology, the University of Texas Medical Branch, Galveston, TX 77555, United States
Monica Chowdhry, Shailendra Singh, Division of Gastroenterology, Department of Internal Medicine, West Virginia University, Charleston, WV 25304, United States
Author contributions: Bilal M and Singh S designed the outline for the manuscript; Shah AR, Al-Hanayneh M, Chowdhry M and Bilal M wrote critical portions of the initial manuscript; Bilal M and Singh S provided expert opinion, and edited the final version of the manuscript.
Conflict-of-interest statement: The authors report no conflict of interest and have no financial disclosures with respect to this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Shailendra Singh, MD, Doctor, Division of Gastroenterology, Department of Internal Medicine, West Virginia University, 3110 MacCorkle Ave SE, Charleston, WV 25304, United States.
Telephone: +1-412-2775244 Fax: +1-409-7723394
Received: December 28, 2018
Peer-review started: December 29, 2018
First decision: March 5, 2019
Revised: March 24, 2019
Accepted: April 8, 2019
Article in press: April 8, 2019
Published online: April 27, 2019

Liver biopsy plays an essential role in the diagnosis, evaluation and management of a vast proportion of liver diseases. Conventionally, percutaneous and trans-jugular approaches have been used to obtain liver biopsies. Endoscopic ultrasound guided liver biopsy (EUS-LB) has emerged as a safe and effective alternate in the past two decades. EUS-LB carries a role in evaluation of both benign and malignant diseases of the liver. It can offer higher resolution imaging of the liver and can detect smaller lesions than computed tomography scan of the abdomen or ultrasound scans with the option for doppler assistance to reduce complications. Current evidence demonstrates the superiority of EUS-LB for a targeted approach of focal lesion and there is also evidence of less sampling variability in heterogeneous parenchymal pathologies. These advantages combined with an improved safety profile had led to the rapid progress in the development of new techniques, equipment and procedures for EUS-LB. We provide a comprehensive review of EUS-LB for parenchymal liver disease.

Keywords: Liver biopsy, Endoscopic ultrasound, Endoscopic ultrasound guided liver biopsy, Liver disease

Core tip: In this review, we provide a comprehensive discussion on the role of Endoscopic ultrasound guided liver biopsy (EUS-LB) in parenchymal liver disease. This article summarized the technical aspects of EUS-LB; as well as debated its advantages and disadvantages. We also highlight new advancements and recently reported research experiences.