Endoscopic ultrasound-guided liver biopsy: Are we ready for routine use?

doi:10.4253/wjge.v18.i2.116625

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Feb 16, 2026 (publication date) through Feb 4, 2026

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World Journal of Gastrointestinal Endoscopy

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1948-5190

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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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

Core Tip

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.