Patient-reported experience measures of EUS-guided and percutaneous liver biopsy. A prospective observational study

Aims Liver biopsy is a critical procedure for diagnosing and staging liver diseases. Traditionally, percutaneous liver biopsy (PC-LB) has been the standard method. Endoscopic ultrasound-guided liver biopsy (EUS-LB) has emerged as a promising alternative. While clinical efficacy and safety have been well-documented, less is known about the patient-reported experience associated with this approach.

This study aims to compare patient-reported experience measures between EUS-LB and PC-LB, providing insight into its impact on patient comfort and satisfaction.

Methods This is a prospective observational study. Within the study period from January to August 2024, we included all consecutive non-targeted EUS-LB and PC-LB at our tertiary liver center. A modified questionnaire based on the validated Newcastle ENDOPREM was used. The questionnaire comprises multiple domains including general demographic information, pain severity (scale 1-10) and duration (scale 1-5), patient discomfort (scale 1-10), well-being, as well as patient satisfaction. Clinical data were recorded from electronic hospital files.

Results This study included 87 patients, of whom 56 underwent EUS-LB and 31 PC-LB. Median age was 54 years (18-74), most patients were male (n=46, 53%). Most common indications for biopsy were either after liver transplantion (n=33, 39%) or for diagnosis of liver disease (n=33, 39%). Technical success was 100%. There was only one major postinterventional complication in the EUS-LB group (bleeding without need for transfusion).

Patients in the EUS-LB group (0(0-8)) reported significantly (p<0.001) less pain during and after the procedure compared to PC-LB group (3(0-10)). Also, duration of pain was significantly (p<0.001) shorter in EUS-LB (1(1-4)) compared to PC-LB (2(1-4)). Finally, patients reported significantly (p=0.006) lower rate of overall discomfort after EUS-LB (0 (0-7)) vs. PC-LB (2(0-8)), while no significant differences were observed in the other domains of the questionnaire.

Conclusions Pain severity, duration and overall discomfort was significantly reduced in EUS-LB compared to PC-LB. The results support the use of EUS-LB as a patient-preferred method for liver biopsy, which could enhance patient compliance and satisfaction.

Publication History

Article published online:
27 March 2025