Diagnostic performance and safety of EUS-guided liver biopsy: A multicenter Latin American comparative study
Jose Ignacio Vargas, Javier Uribe, Sara Maquilon, Oscar Corsi, Felipe Silva, Gabriela Bofill, Fernando Roman, Alejandro Navarrete, Manuel Jaramillo, Catalina Barros, Esteban Parra-Valencia, Javiera Torres, Silvia Alvarez Umaña, Marco Arrese, Luis Antonio Diaz, Jorge Arnold, Roberto Candia, Alberto Espino, Jorge Vargas-MadrigalBackground and Objectives:
Liver biopsy is the gold standard for diagnosing hepatic disease. Although percutaneous liver biopsy (PLB) is the conventional procedure for acquiring liver tissue, it has limitations. EUS-guided liver biopsy (EUS-LB) represents an emerging alternative. This study primarily compared the diagnostic adequacy and safety of EUS-LB and PLB. Secondarily, compared histological quality and safety between Franseen (EUS-FT) and 3-prong asymmetrical tip (EUS-TPT) needles in EUS-LB.
Methods:
We conducted a multicenter, observational study from August 2023 to December 2025, comparing EUS-LB and PLB. Primary outcome was diagnostic sample adequacy according to American Association for the Study of Liver Diseases (AASLD) criteria (≥11 complete portal triads [CPTs] and ≥20 mm length). Secondary outcomes included CPTs, sample length, and 30-day adverse events. EUS-LB outcomes were further compared between EUS-FT and EUS-TPT fine-needle biopsy needles.
Results:
A total of 211 patients were included, comprising 89 EUS-LB and 122 PLB. EUS-LB demonstrated superior sample adequacy (80.9%
Conclusions:
EUS-LB was associated with higher diagnostic adequacy and lower rate of adverse events compared with PLB. Both EUS-FT and EUS-TPT needles are effective and safe for EUS-LB.