Affiliation:
1. Internal Medicine Department, FEEVALE University, Novo Hamburgo, Brazil
2. Pediatric Gastroenterology, Hospital Jaragua, Jaragua do Sul, Brazil
3. Internal Medicine, Evangelical University of Goias, Anápolis, Brazil
4. Endoscopy, Barretos Cancer Hospital, Barretos, Brazil
Abstract
Abstract
Background Percutaneous liver biopsy (PC-LB) has long been the
usual method for acquisition of liver tissue. Recently, endoscopic ultrasound-guided liver
biopsy (EUS-LB) has gained popularity as an alternative modality. We aimed to compare the
efficacy and safety of EUS-LB versus PC-LB.
Methods We systematically searched PubMed, Embase, and the
Cochrane Library databases for randomized controlled trials (RCTs) comparing EUS-LB with PC-LB
published until October 20, 2023. The primary outcome was diagnostic adequacy. Secondary
outcomes were: the number of complete portal tracts (CPTs), longest sample length (LSL), total
sample length (TSL), post-procedure pain scores, and adverse events (AEs), including overall
AEs and AEs excluding minor post-procedure symptoms. We compared binary outcomes using risk
ratios (RRs) and continuous outcomes using the mean difference (MD) or standardized mean
difference (SMD), with 95%CIs.
Results Four RCTs (258 patients) were included. The EUS-LB group
presented lower post-procedure pain scores (SMD −0.58, 95%CI −0.95 to −0.22) than the PC-LB
group. Both groups performed similarly in terms of diagnostic adequacy (RR 1.0, 95%CI 0.96 to
1.04), number of CPTs (MD 2.57, 95%CI −4.09 to 9.22), LSL (MD −2.91 mm, 95%CI −5.86 to 0.03),
TSL (MD 4.16 mm, 95%CI −10.12 to 18.45), overall AEs (RR 0.54, 95%CI 0.20 to 1.46), and AEs
excluding minor post-procedure symptoms (RR 1.65, 95%CI 0.21 to 13.02).
Conclusions This meta-analysis suggests that EUS-LB is as safe
and effective as PC-LB and is associated with lower post-procedure pain scores.Registration on PROSPERO: CRD42023469469.