Table 2.
Comprehensive review of studies on endoscopic ultrasound guided liver biopsy
| Ref. | Study design | n | Indication | Needle used | No of passes | CPTs | TSL | Insufficient sample | Adverse events |
| Wiersema et al[70], 2002 | Prospective cohort | 9 | No medical indication | 19G Tru-cut | NR | 1 | 4 mm | 0 | None |
| Gleeson et al[54], 2008 | Retrospective case series | 9 | Hepatic parenchymal disease | 19G Tru-cut | 2 | 7 | 16.9 mm | 0 | None |
| DeWitt et al[71], 2009 | Prospective case series | 21 | Hepatic parenchymal disease | 19G Tru-cut | 3 | 2 | 9 mm | 10% | None |
| Stavropoulos et al[55], 2012 | Prospective case series | 22 | Abnormal LFTs | 19G FNA (non-Tru-cut) | 2 | 9 | 36.9 mm | 9% | None |
| Gor et al[73], 2014 | Prospective case series | 10 | Abnormal LFTs; Suspected cirrhosis | 19G FNA (non-Tru-cut) | 3 | 9.2 | 14.4 mm | 0 | None |
| Diehl et al[51], 2015 | Retrospective cohort | 110 | Persistent transaminitis | 19G FNA Expect Flexible | 1 to 2 | 14 | 38 mm | 2% | Self-limited bleeding |
| Lee et al[67], 2015 | Prospective cohort | 21 | Rescue for PCLB | 22G FNB, 25G FNB | 2 | NR | NR | 9.50% | None |
| Pineda et al[66], 2016 | Retrospective cohort | 110 | Abnormal LFTs of Unknown Etiology | 19G FNA Expect/Flexible | 3 | 14 | 38 mm | 2% | NR |
| Sey et al[72], 2016 | Prospective Cross-sectional | 75 | Suspected parenchymal disease | 19G FNB ProCore; 19G FNB Tru-Cut | 2; 3 | 5; 2 | 20 mm; 9 mm | 3%; 27% | None; Pain |
| Schulman et al[79], 2017 | Prospective ex-vivo | 48 | No medical indication | 18G1 (percutaneous); 18G2 (percutaneous); 19G FNA Expect; 19G FNB ProCore; 19G FNB SharkCore; 22G FNB SharkCore | 1 to 2 | 2.5; 3.5; 1.9; 1.7; 6.2; 3.8 | NR; NR; NR; NR; NR; NR | 16.7%; 18.7%; 54%; 81%; 14.6%; 14.6% | None |
| Mok et al[53], 2017 | Prospective cross-over | 20 | Elevated LFT Unknown Etiology | 19G FNB; 22G FNB SharkCore | NR | 7.4; 6.1 | 76.5 mm; 66.9 mm | 2.5%; 2.5% | None; Pain |
| Shah et al[75], 2017 | Retrospective chart review | 24 | Abnormal LFTs, pancreaticobiliary disease | 19G FNB SharkCore | 2 | 32.5 | 65.6 mm | 4% | Pain; Subcapsular bleeding |
| Saab et al[87], 2017 | Retrospective chart review | 47 | Biliary tract disease, abnormal LFTs | 19G FNB SharkCore | NR | 18 | 65 mm | 0 | Self-limited liver; hematomas |
| Ching-Companioni et al[83], 2018 | Prospective randomized | 40 | Abnormal LFTs | 19G FNA Expect Flexible; 19G FNB Acquire | 1; 1 | 38; 16.5 | 11.8 mm; 16.3 mm | 0 | Pain |
| Nieto et al[76], 2018 | Prospective observational | 165 | Unexplained abnormal LFTs, biliary obstruction | 19G FNB SharkCore | 1 | 18 | 60 mm | 0 | Abdominal pain; Self-limited hematoma |
| Mok et al[80], 2018 | Prospective cross-over | 40 | Parenchymal liver disease | 19G FNA Expect Flexible; 19G FNA Expect Flexible; 19G FNA Expect Flexible | 3 | 4; 4; 7 | 23.9 mm; 29.7 mm; 49.2 mm | 20%; 7%; 2% | Postprocedural bleeding |
| Rombaoa et al[69], 2018 | Retrospective chart review | 8 | Unexplained abnormal LFTs, hepatitis B staging, cirrhosis | 19G FNB Acquire | 2 | 9.4 | NR | NR | None |
| Shuja et al[68], 2019 | Retrospective observational cohort | 69 | NASH fibrosis staging | 19G FNA Expect Flexible | 3 | 10.84 | 45.8 mm | NR | None |
| Hasan et al[77], 2019 | Prospective nonrandomized trial | 40 | Elevated liver enzymes | 22G FNB Acquire | 2 L; 1 R | 42 | 55 mm | 0 | Self-limiting abdominal pain |
| Bazerbachi et al[78], 2019 | Prospective cohort | 41 | NAFLD diagnosis, staging | 22G FNB Fork-tip | 2 | 26 | 24 mm | 0 | Postprocedural pain |
FNB: Fine needle biopsy; FNA; Fine needle aspiration; TSL; Total Specimen length; CPT: Complete portal tracts; n: Number of study participants; NAFLD: Non-alcoholic fatty liver disease; NASH: Nonalcoholic steatohepatitis.