肝脏穿刺活检操作方法的研究进展
Progress in the Study of Surgical Methods of Liver Biopsy
摘要: 肝脏穿刺活检(liver biopsy，LB，以下简称肝穿活检)是临床医生对肝脏疾病的诊断、预后评估、制定治疗方案的金标准。具体操作方法多样，目前主要有传统的经皮、经颈静脉肝穿活检，以及近年出现的超声内镜引导下的肝穿活检(EUS-guided LB, EUS-LB)。EUS-LB结合了传统方法的优势，可以是经皮和经颈静脉穿刺的有效替代，并且扩大了LB的适应症，具有更好的诊断效果、出色的取样性能和更低的不良事件发生率对操作。同时，EUS-LB相比传统的操作方式，对操作者的要求严格，且价格昂贵。我们需要更多的研究证据来进一步阐明三种操作方式的有效性、安全性和成本效益。
Abstract: Liver biopsy (LB) is the gold standard for the diagnosis, prognosis assessment and treatment of liver diseases. The specific operation methods are various, including traditional percutaneous and transjugular liver biopsy, and EUS-guided liver biopsy (EUS-LB), which appeared in recent years. Combining the advantages of traditional methods, EUS-LB can be an effective alternative to percutaneous and transjugular puncture, and has expanded the indication of LB, with better diagnostic results, excellent sampling performance and lower incidence of adverse events. At the same time, EUS-LB is more demanding on the operator and more expensive than the traditional procedure. More research evidence is needed to further clarify the effectiveness, safety and cost-effectiveness of the three operating methods.
文章引用：白如如, 高倩, 李鑫瑜, 刘欣彤, 刘楠楠, 袁东红. 肝脏穿刺活检操作方法的研究进展[J]. 临床医学进展, 2024, 14(12): 1192-1199. https://doi.org/10.12677/acm.2024.14123205

参考文献

[1] 施漪雯, 范建高. 代谢相关性脂肪性肝病流行现状[J]. 实用肝脏病杂志, 2023, 26(6): 777-780.
[2] 杨蕊旭, 范建高. 非酒精性脂肪性肝病相关肝细胞癌流行病学与筛查[J]. 实用肝脏病杂志, 2022, 25(2): 153-156.
[3] 肖亮. 肝脏穿刺活检湘雅专家共识[J]. 中国普通外科杂志, 2021, 30(1): 1-8.
[4] Rangwani, S., Ardeshna, D.R., Mumtaz, K., Kelly, S.G., Han, S.Y. and Krishna, S.G. (2022) Update on Endoscopic Ultrasound-Guided Liver Biopsy. World Journal of Gastroenterology, 28, 3586-3594. [Google Scholar] [CrossRef] [PubMed]
[5] 李群, 杨宗元, 李月波, 等. 93例次经皮肝穿刺活检的体会[J]. 潍坊医学院学报, 1990(2): 59-61.
[6] Kose, S., Ersan, G., Tatar, B., Adar, P. and Erturk Sengel, B. (2015) Evaluation of Percutaneous Liver Biopsy Complications in Patients with Chronic Viral Hepatitis. The Eurasian Journal of Medicine, 47, 161-164. [Google Scholar] [CrossRef] [PubMed]
[7] Chai, W., Lu, D., Sun, Z., Cheng, C., Deng, Z., Jin, X., et al. (2023) Major Complications after Ultrasound-Guided Liver Biopsy: An Annual Audit of a Chinese Tertiary-Care Teaching Hospital. World Journal of Gastrointestinal Surgery, 15, 1388-1396. [Google Scholar] [CrossRef] [PubMed]
[8] Kariniemi, J., Blanco Sequeiros, R., Ojala, R. and Tervonen, O. (2004) MRI-Guided Abdominal Biopsy in a 0.23-T Open-Configuration MRI System. European Radiology, 15, 1256-1262. [Google Scholar] [CrossRef] [PubMed]
[9] Stattaus, J., Kuehl, H., Ladd, S., Schroeder, T., Antoch, G., Baba, H.A., et al. (2007) CT-Guided Biopsy of Small Liver Lesions: Visibility, Artifacts, and Corresponding Diagnostic Accuracy. CardioVascular and Interventional Radiology, 30, 928-935. [Google Scholar] [CrossRef] [PubMed]
[10] 张雪哲, 卢延, 王武洪, 闻陆立. 磁共振成像导引肝脏穿刺活检[J]. 中华医学杂志, 2001, 81(16): 968-970.
[11] 徐晓军, 黄江波, 宋炜. CT、MRI检查对小肝癌的诊断价值[J]. 癌症进展, 2024, 22(6): 670-672, 696.
[12] 王利英, 蒋天安, 郑树森. 超声造影引导下穿刺活检在肝占位性病变中的应用价值[J]. 中华医学超声杂志(电子版), 2018, 15(6): 458-463.
[13] 黎腊安. 超声造影引导下穿刺活检在肝脏占位性病变中的应用[J]. 影像研究与医学应用, 2023, 7(18): 194-196.
[14] Yoo, J. and Lee, D.H. (2024) Usefulness of Contrast-Enhanced Ultrasound-Guided Biopsy for Suspected Viable Hepatocellular Carcinoma after Treatment: A Single-Arm Prospective Study. Ultrasonography, 43, 88-97. [Google Scholar] [CrossRef] [PubMed]
[15] García-Compean, D. and Cortés, C. (2004) Transjugular Liver Biopsy. An Update. Annals of Hepatology, 3, 100-103. [Google Scholar] [CrossRef] [PubMed]
[16] Sue, M.J., Lee, E.W., Saab, S., McWilliams, J.P., Durazo, F., El-Kabany, M., et al. (2019) Transjugular Liver Biopsy: Safe Even in Patients with Severe Coagulopathies and Multiple Biopsies. Clinical and Translational Gastroenterology, 10, e00063. [Google Scholar] [CrossRef] [PubMed]
[17] Gerasia, R., Gallo, G.S., Tafaro, C., Cucchiara, A., Maruzzelli, L. and Miraglia, R. (2021) Transjugular Biopsy of a Liver Focal Lesion in an Obese Patient Using Cone-Beam Computed Tomography Guidance. Radiography, 27, 751-753. [Google Scholar] [CrossRef] [PubMed]
[18] Miraglia, R., Maruzzelli, L., Minervini, M.I., Mamone, G., Caruso, S., Cintorino, D., et al. (2008) Transjugular Biopsy of an Atypical Focal Nodular Hyperplasia in a Patient with Acute Liver Failure Clinical Presentation. Emergency Radiology, 16, 223-225. [Google Scholar] [CrossRef] [PubMed]
[19] Hamaguchi, S., Nakashima, Y., Dote, M., Wada, S., Hashimoto, K. and Mimura, H. (2024) Successful Diagnosis of a Localized Liver Tumor via Transjugular Liver Biopsy after Ascites Hampered a Percutaneous Approach. Radiology Case Reports, 19, 117-121. [Google Scholar] [CrossRef] [PubMed]
[20] Hansen, N. and Fialla, A.D. (2023) Complications in Hepatic Vein Catheterisation and Transjugular Liver Biopsy. Danish Medical Journal, 71, A06230413.
[21] Neuberger, J., Patel, J., Caldwell, H., Davies, S., Hebditch, V., Hollywood, C., et al. (2020) Guidelines on the Use of Liver Biopsy in Clinical Practice from the British Society of Gastroenterology, the Royal College of Radiologists and the Royal College of Pathology. Gut, 69, 1382-1403. [Google Scholar] [CrossRef] [PubMed]
[22] Stift, J., Semmler, G., Wöran, K., Simbrunner, B., Scheiner, B., Schwabl, P., et al. (2020) Comparison of the Diagnostic Quality of Aspiration and Core-Biopsy Needles for Transjugular Liver Biopsy. Digestive and Liver Disease, 52, 1473-1479. [Google Scholar] [CrossRef] [PubMed]
[23] 陆靖怡, 曲颖, 陆伦根. 内镜技术在肝脏疾病诊断治疗中的应用及发展[J]. 临床肝胆病杂志, 2024, 40(4): 834-838.
[24] Ramai, D., Pannu, V., Facciorusso, A., Dhindsa, B., Heaton, J., Ofosu, A., et al. (2023) Advances in Endoscopic Ultrasound (EUS)-Guided Liver Biopsy. Diagnostics, 13, Article 784. [Google Scholar] [CrossRef] [PubMed]
[25] Chong, C.C., Pittayanon, R., Pausawasdi, N., Bhatia, V., Okuno, N., Tang, R.S., et al. (2024) Consensus Statements on Endoscopic Ultrasound‐guided Tissue Acquisition. Guidelines from the Asian Endoscopic Ultrasound Group. Digestive Endoscopy, 36, 871-883. [Google Scholar] [CrossRef] [PubMed]
[26] Laleman, W., Vanderschueren, E., Mehdi, Z.S., Wiest, R., Cardenas, A. and Trebicka, J. (2024) Endoscopic Procedures in Hepatology: Current Trends and New Developments. Journal of Hepatology, 80, 124-139. [Google Scholar] [CrossRef] [PubMed]
[27] Khurana, S., Butt, W., Khara, H.S., Johal, A.S., West, S.F., Chen, Z.E., et al. (2019) Bi-Lobar Liver Biopsy via EUS Enhances the Assessment of Disease Severity in Patients with Non-Alcoholic Steatohepatitis. Hepatology International, 13, 323-329. [Google Scholar] [CrossRef] [PubMed]
[28] Sharma, M., Lakhtakia, S., Jagtap, N., Sekaran, A., Kalapala, R., Jahangeer, B., et al. (2022) EUS-Guided Left Lobe Liver Biopsy: Safer Modality with Similar Diagnostic Yield as Right Lobe: A Pilot Study. Endoscopy International Open, 11, E172-E178. [Google Scholar] [CrossRef] [PubMed]
[29] Johal, A., Khara, H., Maksimak, M. and Diehl, D. (2014) Endoscopic Ultrasound-Guided Liver Biopsy in Pediatric Patients. Endoscopic Ultrasound, 3, 191-194. [Google Scholar] [CrossRef] [PubMed]
[30] McCarty, T.R., Bazarbashi, A.N., Njei, B., Ryou, M., Aslanian, H.R. and Muniraj, T. (2020) Endoscopic Ultrasound-Guided, Percutaneous, and Transjugular Liver Biopsy: A Comparative Systematic Review and Meta-Analysis. Clinical Endoscopy, 53, 583-593. [Google Scholar] [CrossRef] [PubMed]
[31] Takano, Y., Noda, J., Yamawaki, M., Azami, T., Kobayashi, T., Niiya, F., et al. (2021) Comparative Study of an Ultrasound-Guided Percutaneous Biopsy and Endoscopic Ultrasound-Guided Fine-Needle Aspiration for Liver Tumors. Internal Medicine, 60, 1657-1664. [Google Scholar] [CrossRef] [PubMed]
[32] 马文培, 黄芳, 童婷, 等. 超声内镜引导下肝活检术与经皮肝活检术不同活检针在肝占位病变中的应用对比研究[J]. 中国医学装备, 2022, 19(3): 110-111.
[33] Facciorusso, A., Ramai, D., Conti Bellocchi, M.C., Bernardoni, L., Manfrin, E., Muscatiello, N., et al. (2021) Diagnostic Yield of Endoscopic Ultrasound-Guided Liver Biopsy in Comparison to Percutaneous Liver Biopsy: A Two-Center Experience. Cancers, 13, Article 3062. [Google Scholar] [CrossRef] [PubMed]
[34] Atar, E., Ben Ari, Z., Bachar, G.N., Amlinski, Y., Neyman, C., Knizhnik, M., et al. (2009) A Comparison of Transjugular and Plugged-Percutaneous Liver Biopsy in Patients with Contraindications to Ordinary Percutaneous Liver Biopsy and an “In-House” Protocol for Selecting the Procedure of Choice. CardioVascular and Interventional Radiology, 33, 560-564. [Google Scholar] [CrossRef] [PubMed]
[35] Sun, C., Zhao, X., Shi, L., Fan, X. and Qi, X. (2023) Distinct Ways to Perform a Liver Biopsy: The Core Technique Setups and Updated Understanding of These Modalities. Endoscopic Ultrasound, 12, 437-444. [Google Scholar] [CrossRef] [PubMed]
[36] Diehl, D., Johal, A., Khara, H., Stavropoulos, S., Al-Haddad, M., Ramesh, J., et al. (2015) Endoscopic Ultrasound-Guided Liver Biopsy: A Multicenter Experience. Endoscopy International Open, 3, E210-E215. [Google Scholar] [CrossRef] [PubMed]
[37] Chen, M., Yang, A., Hu, Y., Yang, Y., Xiong, Q., Zhong, Y., et al. (2023) Transjugular Liver Biopsy: Enlarge the Indications for Liver Biopsy with Reliable Diagnostic Quality. BMC Gastroenterology, 23, Article No. 282. [Google Scholar] [CrossRef] [PubMed]
[38] Cao, W., Cheng, Z., Wang, L., Zhao, X., Li, J. and Zhou, S. (2021) Analysis of Risk Factors of Bleeding Complications in Percutaneous Needle Biopsy of Liver Occupying Lesions. International Journal of General Medicine, 14, 2893-2899. [Google Scholar] [CrossRef] [PubMed]
[39] Kalambokis, G., Manousou, P., Vibhakorn, S., Marelli, L., Cholongitas, E., Senzolo, M., et al. (2007) Transjugular Liver Biopsy—Indications, Adequacy, Quality of Specimens, and Complications—A Systematic Review. Journal of Hepatology, 47, 284-294. [Google Scholar] [CrossRef] [PubMed]

为你推荐