P0839 - A Single Center Comparison of EUS-Guided and Percutaneous Liver Biopsy

Aran Farrell, MD¹, Ambreen A. Merchant, MD¹, Vishal Kaila, MD¹, Robert Anderson, MD¹, Hemangi Kale, MD¹, Ranjeeta Bahirwani, MD¹, Sumeet Asrani, MD², Rushikesh Shah, MD^1
1Baylor University Medical Center, Dallas, TX; ²Baylor University Medical Menter, Dallas, TX

Introduction: Endoscopic ultrasound guided liver biopsy (EUS-LB) has emerged as an effective alternative to percutaneous liver biopsy (PC-LB). EUS-LB and PC-LB also have comparable safety profiles. There are several theoretical advantages of EUS-LB including improved tolerability among patients, less pain and faster recovery times. Here, we compare post-procedure pain, time spent in recovery, adequacy of the sample and adverse events.







Methods: This is a single center retrospective study. EUS-LB and PC-LB were identified retrospectively. EUS-LB was obtained with a 19-gauge Francine tip biopsy needle using a transgastric (left hepatic lobe) and transduodenal (right hepatic lobe) approach. PC-LB was obtained with a Biopince 18-gauge fine needle biopsy. Data was collected from chart review. Pain was documented on a 0 to 10 pain intensity numerical rating scale while in the recovery unit. For EUS-LB, time required in the post anesthesia recovery unit was documented.







Results: A total of 90 patients who underwent EUS-LB (n=30) and PC-LB (n=60) were compared. Clinical success defined as adequate tissue sample for diagnosis was 100% and 97.3% for EUS-LB and PC-LB, respectively. The highest post-procedural pain score was numerically lower in EUS-LB group but did not reach level of statistical significance (1.7 vs 3.05 p = 0.07). Absence of pain throughout the recovery phase was documented in 60% of patients who underwent EUS-LB compared to 38.3% of PC-LB. Mean time spent in the recovery unit for EUS-LB was 79.1 minutes. For PC-LB, the institutional protocol is 180 minutes in recovery. There were no major adverse events in both groups. There were two minor adverse events after PC-LB (3.3%) and none after EUS-LB. Minor adverse events included severe pain in which CT scan was unremarkable for active bleeding, and a moderate allergic skin rash over the percutaneous procedural site.







Discussion: It is previously documented that EUS-LB and PC-LB are similar when comparing sample adequacy and complication rates. EUS-LB offers less post-procedure pain and less time in recovery with comparable diagnostic yield to PC-LB. EUS-LB is an effective and more tolerable approach for patients requiring liver biopsy and planning to undergo an endoscopic procedure.



Disclosures:


Aran Farrell, MD¹, Ambreen A. Merchant, MD¹, Vishal Kaila, MD¹, Robert Anderson, MD¹, Hemangi Kale, MD¹, Ranjeeta Bahirwani, MD¹, Sumeet Asrani, MD², Rushikesh Shah, MD¹. P0839 - A Single Center Comparison of EUS-Guided and Percutaneous Liver Biopsy, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.