Efficacy and Diagnostic Yield of 19G Versus 22G Fine Needle Biopsy Needles in EUS-Guided Liver Bbiopsy: A Systematic Review and Meta-Analysis

Division

North Florida

Hospital

North Florida Regional Medical Center

Document Type

Manuscript

Publication Date

12-15-2025

Keywords

19-Gauge, 22-Gauge, EUS, Fine needle biopsy, Liver biopsy

Disciplines

Diagnosis | Internal Medicine | Medicine and Health Sciences

Abstract

EUS-guided liver biopsy (EUS-LB) is an alternative to traditional percutaneous and transjugular approaches. Determining the optimal needle gauge requires balancing diagnostic yield with procedural safety. This meta-analysis compares the efficacy and safety of 19-gauge (19G) versus 22-gauge (22G) fine needle biopsy (FNB) needles in EUS-LB. We searched PubMed, Google Scholar, and Cochrane databases for studies comparing 19G and 22G FNB needles with Franseen or Fork tip designs. Outcomes assessed included tissue adequacy, diagnostic adequacy, number of complete portal tracts (CPTs), length of the longest tissue segment, and total specimen length (TSL). Data were analyzed using a random-effects model, presenting results as standardized mean differences (SMDs) and relative risks (RRs) with 95% confidence intervals (CIs). Five studies with 205 patients were included. The 19G needle demonstrated higher tissue adequacy (RR, 1.596; 95% CI, 0.969-2.631; P = 0.066) and diagnostic adequacy (RR, 1.421; 95% CI, 0.942-2.145; P = 0.094) compared to the 22G needle. It yielded greater CPTs (SMD, 1.705; 95% CI, -0.652 to 4.062; I 2 = 97.34%), longer tissue segments (SMD, 5.039; 95% CI, -0.276 to 10.354; I 2 = 97.24%), and increased TSL (SMD, 4.156; 95% CI, -0.268 to 8.579; I 2 = 98.75%). The 19G needle may provide superior tissue and diagnostic outcomes in EUS-LB without increasing adverse effects compared to the 22G needle, although these differences were not statistically significant. This suggests a need for further high-quality research to confirm these preliminary findings.

Publisher or Conference

Endoscopic Ultrasound

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