Rapid versus slow puncture in endoscopic ultrasound-guided liver biopsy: a multicenter randomized crossover trial
In brief
Rapid puncture yields 2.4 more portal tracts per specimen in liver biopsy
In a 62-specimen multicenter randomized crossover trial, rapid puncture produced an average of 2.4 more complete portal tracts and 15 mm more tissue than slow puncture, with better diagnostic adequacy. No severe adverse events were reported. The findings favor rapid puncture for specimen quality, but larger studies in more diverse populations are needed to confirm its value in practice.
- Journal
- Endoscopy (Q1)
- Published
- 16 October 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Ying Wu, Ying Qu, Wen Wen, Ni Xie, Guanhao Su, Kai Xu, et al.
- PMID
- 42887540
- DOI
- 10.1055/a-2957-0455
Why clinicians should know about it
- Picked for Pathology and Forensic Medicine (top studies of the week, 18 October 2026): Rapid puncture improves portal tract yield in EUS‑LB
Abstract
BACKGROUND: Endoscopic ultrasound-guided liver biopsy (EUS-LB) is increasingly used for hepatic histologic assessment; however, optimal technical approaches remain undefined. This prospective, multicenter clinical study aimed to compare tissue acquisition and safety between the rapid and slow puncture techniques for EUS-LB. METHODS: This was a multicenter randomized crossover study. Patients undergoing EUS-LB were randomized to receive both rapid puncture and slow puncture techniques in alternating sequence during the same session. The primary outcomes were the number of complete portal tracts (CPTs) and total specimen length (TSL). The secondary outcomes were diagnostic adequacy and adverse events. Linear mixed models and generalized linear mixed models were used to evaluate the technical performance. RESULTS: A total of 62 specimens were analyzed. Compared with the conventional slow puncture technique, rapid puncture significantly increased CPTs (mean difference 2.39; 95%CI 1.50-3.27), as well as TSL (mean difference 15.19 mm; 95%CI 9.65-20.74), with corresponding improvements in diagnostic adequacy (odds ratio 16.27, 95%CI 2.41-109.97). Time period and center were not statistically significantly associated with the outcomes. No severe adverse events were reported. CONCLUSION: The modified rapid puncture technique was associated with improved specimen quality in EUS-LB. These findings support its potential utility in clinical practice; however, further validation in larger and more diverse populations is warranted.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.