Antonini F, Anderloni A, Fabbri C, Tarantino I, Facciorusso A. Endoscopic ultrasound-guided liver biopsy: Are we ready for routine use? World J Gastrointest Endosc 2026; 18(2): 116625 [DOI: 10.4253/wjge.v18.i2.116625]
Corresponding Author of This Article
Filippo Antonini, Director, Chief Physician, Department of Gastroenterology and Interventional Endoscopy Unit, C. e G. Mazzoni Hospital, Via degli Iris 1, Ascoli Piceno 63100, Marche, Italy. filippore@yahoo.it
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
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: http://creativecommons.org/licenses/by-nc/4.0/
Feb 16, 2026 (publication date) through Feb 4, 2026
Times Cited of This Article
Times Cited (0)
Journal Information of This Article
Publication Name
World Journal of Gastrointestinal Endoscopy
ISSN
1948-5190
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Antonini F, Anderloni A, Fabbri C, Tarantino I, Facciorusso A. Endoscopic ultrasound-guided liver biopsy: Are we ready for routine use? World J Gastrointest Endosc 2026; 18(2): 116625 [DOI: 10.4253/wjge.v18.i2.116625]
World J Gastrointest Endosc. Feb 16, 2026; 18(2): 116625 Published online Feb 16, 2026. doi: 10.4253/wjge.v18.i2.116625
Endoscopic ultrasound-guided liver biopsy: Are we ready for routine use?
Filippo Antonini, Andrea Anderloni, Carlo Fabbri, Ilaria Tarantino, Antonio Facciorusso
Filippo Antonini, Gastroenterology and Interventional Endoscopy Unit, C. e G. Mazzoni Hospital, Ascoli Piceno 63100, Italy
Andrea Anderloni, Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia 27100, Italy
Andrea Anderloni, Gastroenterology and Digestive Endoscopy Unit, Fondazione I.R.C.C.S. Policlinico San Matteo, Pavia 27100, Italy
Carlo Fabbri, Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, Ausl Romagna, Forlì 47121, Italy
Ilaria Tarantino, Gastroenterology and Hepatology Unit, IRCCS ISMETT, UPMC Italy, Palermo 90127, Italy
Antonio Facciorusso, Gastroenterology Unit, Department of Experimental Medicine, University of Salento, Lecce 73100, Puglia, Italy
Author contributions: Antonini F designed and wrote the editorial; Anderloni A, Fabbri C, and Tarantino I supervised the manuscript preparation; Facciorusso A contributed to reviewing and editing; and all authors have read and approved the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Filippo Antonini, Director, Chief Physician, Department of Gastroenterology and Interventional Endoscopy Unit, C. e G. Mazzoni Hospital, Via degli Iris 1, Ascoli Piceno 63100, Marche, Italy. filippore@yahoo.it
Received: November 18, 2025 Revised: December 20, 2025 Accepted: January 13, 2026 Published online: February 16, 2026 Processing time: 80 Days and 11.6 Hours
Abstract
Endoscopic ultrasound-guided liver biopsy (EUS-LB) is increasingly used for the evaluation of parenchymal liver disease, with recent multicenter data demonstrating high diagnostic yield and a low rate of serious adverse events. While EUS-LB offers technical flexibility through different needle sizes, suction techniques, and limited passes, its overall diagnostic outcomes, including specimen length, portal tract count, and sample adequacy, are comparable to standard percutaneous liver biopsy. Despite these encouraging results, EUS-LB is more invasive, requiring sedation and endoscopic expertise, and is substantially more costly than percutaneous-liver biopsy. Therefore, while EUS-LB is valuable in select clinical scenarios, current evidence does not support its routine use for parenchymal liver disease, and further prospective studies are needed to define its role relative to established percutaneous approaches.
Core Tip: Endoscopic ultrasound-guided liver biopsy (EUS-LB) has emerged as a feasible and safe alternative to percutaneous liver biopsy for evaluating parenchymal liver disease. However, comparative evidence shows equivalent diagnostic adequacy and safety between the two techniques, with percutaneous liver biopsy yielding lower procedural costs. EUS-LB remains more invasive and resource-intensive, requiring endoscopic expertise and sedation. While EUS-LB is valuable when combined with other endoscopic interventions or when percutaneous access is not feasible, current data do not justify its routine use. Future studies should focus on cost-effectiveness, standardization, and patient-centered outcomes before broader adoption.
