Diagnostic yield of endoscopic ultrasound-guided liver biopsy in comparison to percutaneous liver biopsy: a systematic review and meta-analysis

ABSTRACT

Background

It is still unclear whether endoscopic ultrasound liver biopsy (EUS-LB) determines superior results in comparison to percutaneous liver biopsy (PC-LB). Aim of this meta-analysis was to compare the diagnostic outcomes of these two techniques.

Research Design and Methods

Literature search was conducted through June 2021 and identified 7 studies. The primary outcome was total length of specimen. Results were expressed as odds ratio (OR) or mean difference along with 95% confidence interval (CI).

Results

Pooled total length of specimen was 29.9 mm (95% CI 24.1–35.7) in the EUS-LB group and 29.7 mm (95% CI 27.1–32.2) in the PC-LB group, with no difference between the two approaches (mean difference −0.35 mm, 95% CI −5.31 to 4.61; p = 0.89), although sensitivity analysis restricted to higher quality studies found a superior performance of PC-LB over EUS-LB. Pooled number of complete portal tracts was 12.9 (7.7–18) in the EUS-LB and 14.4 (10.7–18) in the PC-LB group, with no difference in direct comparison (mean difference −1.58, −5.98 to 2.81; p = 0.48). No difference between the two groups was observed in terms of severe adverse event rate (OR 1.11, 0.11–11.03; p = 0.93).

Conclusion

EUS-LB and PC-LB are comparable in terms of diagnostic performance and safety profile.

KEYWORDS:

• EUS
• FNB
• FNA
• adequacy

Declaration of interests

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Study concept and design: A Facciorusso designed the study, worked on the acquisition of data, conducted the statistical analysis, and drafted the manuscript. A Lisotti and SF Crinò drafted the manuscript. D Ramai, C Fabbri, B Mangiavillano, N Muscatiello, C Cotsoglou and P Fusaroli critically revised the final manuscript. All of the authors approved the final version of the manuscript.

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

This paper was not funded.