Published online Mar 16, 2020. doi: 10.4253/wjge.v12.i3.83
Peer-review started: October 25, 2019
First decision: November 5, 2019
Revised: December 26, 2019
Accepted: March 1, 2020
Article in press: March 1, 2020
Published online: March 16, 2020
Processing time: 139 Days and 12.3 Hours
Liver biopsy (LB) is an essential tool in diagnosing, evaluating and managing various diseases of the liver. As such, histopathological results are critical as they establish or aid in diagnosis, provide information on prognosis, and guide the appropriate selection of medical therapy for patients. Indications for LB include evaluation of persistent elevation of liver chemistries of unclear etiology, diagnosis of chronic liver diseases such as Wilson's disease, autoimmune hepatitis, small duct primary sclerosing cholangitis, work up of fever of unknown origin, amyloidosis and more. Traditionally, methods of acquiring liver tissue have included percutaneous LB (PCLB), transjugular LB (TJLB) or biopsy taken surgically via laparotomy or laparoscopy. However, traditional methods of LB may be inferior to newer methods. Additionally, PCLB and TJLB carry higher risks of adverse events and complications. More recently, endoscopic ultrasound guided LB (EUS-LB) has evolved as an alternative method of tissue sampling that has proven to be safe and effective, with limited adverse events. Compared to PC and TJ routes, EUS-LB may also have a greater diagnostic yield of tissue, be superior for a targeted approach of focal lesions, provide higher quality images and allow for greater patient comfort. These advantages have contributed to the increased use of EUS-LB as a technique for obtaining liver tissue. Herein, we provide a review of the recent evidence of EUS-LB for liver disease.
Core tip: Endoscopic ultrasound guided liver biopsy is a safe and effective approach to obtaining liver biopsies that may serve as an alternative to traditional methods. Our goal is to collect and review the most recent data on the advances in endoscopic ultrasound guided liver biopsies, while also weighing the advantages and disadvantages of utilizing conventional methods of liver biopsy (percutaneous liver biopsy, transjugular liver biopsy, surgical liver biopsy).