Comparing the diagnostic performance of 19-gauge and 22-gauge needles in endoscopic ultrasound-guided liver biopsy: a systematic review and meta-analysis

Department

Internal Medicine

Document Type

Article

Publication Title

Proceedings (Baylor University. Medical Center)

Abstract

Background: Liver biopsy is the gold standard for histologic diagnosis of parenchymal liver disease. Endoscopic ultrasound-guided liver biopsy (EUS-LB) is increasingly being performed for tissue acquisition. However, the needle size to perform the procedure is still debated. We performed a systematic review and meta-analysis comparing outcomes and safety of two different needles, 19 gauge (G) and 22 G, for EUS-LB.

Methods: A comprehensive search of multiple databases was conducted to identify studies comparing 19 G and 22 G needles for liver biopsy. Studies reporting tissue adequacy, histologic diagnosis, and other relevant outcomes were included. A meta-analysis was conducted using random-effects models, and heterogeneity was assessed using standard methods.

Results: Our analysis of six studies revealed the superiority of 19 G needles in terms of tissue adequacy (odds ratio [OR] 7.9, 95% confidence interval [CI] 1.9-32.0, P = 0.004) and obtaining a histological diagnosis (OR 7.25, 95% CI 1.4-36.7, P = 0.02) compared to 22 G needles. Both needle sizes performed similarly in obtaining long intact core preprocessing; however, 19 G needles yielded significantly longer intact cores postprocessing. Postprocedural pain was similar between groups.

Conclusion: Our meta-analysis supports the preferential use of 19 G needles over 22 G needles for EUS-LB, given their superior performance in tissue adequacy and histological diagnosis with no difference in postprocedural adverse events. These findings underscore the importance of appropriate needle size in optimizing EUS-LB outcomes.

First Page

877

Last Page

883

DOI

10.1080/08998280.2026.2684890

Volume

39

Issue

5

Publication Date

9-1-2026

Medical Subject Headings

Humans; Needles; Liver; Liver Diseases; Endoscopic Ultrasound-Guided Fine Needle Aspiration

PubMed ID

42330162

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