Experience in Using 19G Endoscopic Ultrasound (EUS) Needle in Diagnosing Liver Parenchymal Diseases - A Prospective Observational Pilot Study

ABSTRACT: Background And Aim: Endoscopic ultrasound (EUS) using a 19G needle has emerged as a safe and effective method for diagnosing liver parenchymal disease. This pilot study aims to present our experience with this new technique, including it's diagnostic yield, technical success, and potential complications. Methods: In this prospective study, 20 patients with indications for liver biopsy (Cirrhosis-5, NASH-8, AIH-4, NCPF-1, HBV FLARE-1, ACUTE HEPATITIS-1) underwent EUS-LB with a 19-gauge fine-needle biopsy (FNB) needle from left lobes using wet heparin suction technique using 2 passes. The primary outcome was the adequacy of the sample to render a diagnosis. Secondary outcomes were total specimen length (TSL), length of Longest Piece (LLP), and complete portal tracts (CPTs). Adverse outcomes after the procedure were also documented. Result: The most common indication for EUS-guided liver biopsy was NASH. The technical success rate of the procedure was 100%, indicating a high rate of successful needle placement. Histological diagnosis was made in 20 patients (100%). The median number of CPTs was 16 (6-29), while the median of TSL was 4.5 cm (3-7.5) and the median LLP was 2.5 cm (1-4.5). The median Pain score (VAS) was 0 (0-5). There was no major complication except for one of the patients who had a bleed from the gastric puncture site, which was managed with hemoclip placement without the need for blood transfusion. Conclusion: In conclusion, our results suggest that the use of a 19G EUS needle for liver parenchymal sampling is a safe and effective approach to diagnosing liver parenchymal diseases. This technique has the potential to enhance diagnostic accuracy, facilitate appropriate management decisions, and improve patient outcomes with minimal pain.