P- 84 ENDOSCOPIC ULTRASOUND GUIDED LIVER BIOPSY, IS IT READY FOR PRIMETIME?

Introduction and Objectives

Endoscopic ultrasound-guided liver biopsy (EUS-LB) has been proposed as a novel technique that could offer some advantages over traditional methods, especially regarding specimen adequacy. A systematic review that included 32 studies evaluating the quality of percutaneous hepatic biopsies (PC-LB) demonstrated that the average number of portal tracts with this technique was 7.5 +/-3.4. (1) The objective of our study was to determine if EUS-LBs meet AASLD quality criteria, defined by the presence of more than 11 portal tracts.

Materials and Methods

A retrospective study was carried out from a prospectively created EUS-LB database. The primary objective was to evaluate the sample quality, using as a parameter the number of portal tracts. The secondary objective was to determine the security profile of the procedure and evaluate the rate of complications.

Results

82 patients were included (average age 55). The main indication for tissue acquisition was elevated transaminases. Steatosis/steatohepatitis was the most common histological diagnosis. The average number of portal tracts was 19.23 +/- 7.2. All the samples had at least 11 portal tracts. The rate of adverse events was 9.75%. The majority were minor complications (post-procedure pain). Only one patient presented a severe complication, bleeding secondary to an arterio-biliary fistula, that required embolization by interventional radiology.

Conclusions

EUS-LBs meet quality criteria established by AASLD, have an excellent security profile, and might be considered the method of choice for liver tissue acquisition in the centers where the resource is available.