Clin Endosc.  2021 Sep;54(5):739-744. 10.5946/ce.2020.212.

Superior Specimen and Diagnostic Accuracy with Endoscopic Ultrasound-Guided Liver Biopsies Using 19-Gauge versus 22-Gauge Core Needles

• Shah RM
• Schmidt J
• John E
• Rastegari S
• Acharya P
• Kedia P

• KMID: 2520558
• DOI: http://doi.org/10.5946/ce.2020.212

Abstract

Background/Aims
Endoscopic ultrasound-guided liver biopsy (EUS-LB) is an effective and safe method of procuring liver tissue. The aims of this study were to assess and compare the outcomes and tissue adequacy of a single-pass, single-actuation, wet suction technique between 19 G and 22 G needles in patients undergoing EUS-LB.
Methods
We performed a prospective case series study of 20 patients undergoing EUS-LB at a single center between September 2017 and April 2020. The primary objective was to evaluate differences in sample adequacy via a single actuation wet suction technique between a 19 G core needle and a 22 G core needle. Adequacy was gauged by cumulative core biopsy length and the number of portal tracts visualized.
Results
The 19 G needle provided a longer core length (2.5 cm vs. 1.2 cm, p<0.0001), more complete portal tracts (5.8 vs. 1.7, p<0.0001), more total tracts (8.8 vs. 3, p<0.0001), and a longer, intact, fragment length (0.75 cm vs. 0.32 cm, p<0.0006). The 19 G needle was superior in providing adequate (60% vs. 5%, p<0.001) and diagnostic pathologic samples (85% vs. 10%, p<0.001).
Conclusions
A single-pass, single-actuation, wet suction technique using a 19 G needle is superior to that using a 22 G needle for tissue acquisition and sample adequacy in EUS-LB.

Keyword

19 G FNB; Endoscopic ultrasound-guided liver biopsy; Liver biopsy

Figure

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  Fig. 1. Endoscopic ultrasound-guided liver biopsy core sampling, 19 gauge fine-needle aspiration needle.

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