scholarly journals Complications and Efficiency of Liver Biopsies using the Tru-Cut Biopsy Gun

2009 ◽  
Vol 4 (02) ◽  
pp. 091-095 ◽  
Author(s):  
Figen Caglan Cevik ◽  
Nevil Aykin ◽  
Hasan Naz
Keyword(s):  
Liver Biopsy ◽  
Chronic Viral Hepatitis ◽  
Percutaneous Liver Biopsy ◽  
Ultrasound Guided ◽  
Biopsy Site ◽  
Major Complications ◽  
Significant Difference ◽  
Liver Biopsies ◽  
Liver Bleeding

Objectives: The study aimed to evaluate the complications and quality of the specimens of percutaneous liver biopsy in patients with chronic viral hepatitis who were scheduled for treatment and also to evaluate the contribution of the knowledge of ultrasound guided (USG) biopsy localization to the existing data. Methodology: Liver biopsies conducted at our clinic between 2003 and 2008 were retrospectively evaluated. In 53.8% of the cases, hepatobiliary USG was performed to mark the localization of the biopsy site. An automatically triggered Tru-Cut biopsy gun was used. Results: Biopsies waere taken from the livers of 236 patients (46.6% male, 53.4% female) with a mean age of 47.1 ± 12.5 years. The majority of patients had hepatitis C (61.9%); 1.6% experienced major complications (3 patient biliary peritonitis, 1 patient liver bleeding); 52.1% of the samples were ≥ 1 cm in length; And 69.7% of the biopsy samples with specified portal area had ≥ 4 portal areas. There was no statistically significant difference between the  patients with localized and non-localized biopsy site in terms of major complications and length of biopsy samples ( respectively p = 1.000, p = 0.209 ). Conclusion: We believe that percutaneous liver biopsy using Tru-Cut biopsy gun can be peformed safely, with complications in 1.6% of the procedures. The length of the biopsy specimen is shorter than ideal values. Evaluation of the patients with and without USG-guided biopsy revealed no significant difference in terms of major complications and specimen size.

scholarly journals Increased Needle Visibility in Ultrasound-Guided Percutaneous Liver Biopsy by an Echogenic Sheath: A Proof of Concept Study in a Human Cadaver

2021 ◽  
Author(s):  
Jana S. Hopstaken ◽  
Leon de Jong ◽  
Jurgen J. Fütterer
Keyword(s):  
Pilot Study ◽  
Liver Biopsy ◽  
Human Cadaver ◽  
Percutaneous Liver Biopsy ◽  
Ultrasound Guided ◽  
Biopsy Needle ◽  
Phantom Model ◽  
Likert Score ◽  
Contrast Analysis ◽  
Needle Visibility

Abstract Purpose For the safety and success of an ultrasound-guided percutaneous liver biopsy, needle visibility and needle tip identification are critical. The aim of this pilot study was to evaluate the influence of an innovative echogenic sheath placed over a standard biopsy needle on needle visibility in ultrasound imaging. Materials and methods Ultrasound videos of three sheaths with different coating characteristics (echogenicity) and one conventional liver biopsy needle were recorded at two angles (30° and 60°) and two depths (5 and 10 cm) in a human cadaver. The videos were blinded for needle type and presented to five independent radiologists who used Likert-scale scoring to rank each video for six characteristics on needle visibility. In addition, a phantom model was used to acquire standardized images for quantitative evaluation of the ultrasound visibility. Comparative statistical analysis consisted of a one-way ANOVA. Results The three prototype sheaths were ranked higher than the control needle at 60° with 5 cm depth, with an equal performance for the other conditions. The radiologists expressed more confidence in taking a biopsy with the echogenic sheaths than with the control needle, with 1 Likert score difference at 30°. Contrast analysis in the phantom model showed a statistically significant effect of a sheath (p = 0.004) on echogenic intensity. Conclusion This pilot study suggests that the use of an echogenic sheath may increase needle visibility, particularly for trajectories requiring steeper insertion angles. To investigate the superiority of the echogenic sheath over conventional needles, a clinical study is necessary.

scholarly journals Liver Biopsies for Chronic Hepatitis C: Should Nonultrasound-Guided Biopsies Be Abandoned?

2009 ◽  
Vol 23 (6) ◽  
pp. 425-430 ◽  
Author(s):  
Jennifer A Flemming ◽  
David J Hurlbut ◽  
Ben Mussari ◽  
Lawrence C Hookey
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Biopsy ◽  
Chronic Hepatitis C ◽  
Hcv Infection ◽  
Significant Difference ◽  
The Us ◽  
Chronic Hcv Infection ◽  
Liver Biopsies ◽  
Chronic Hcv

BACKGROUND/OBJECTIVE: Liver biopsy has been the gold standard for grading and staging chronic hepatitis C virus (HCV)-mediated liver injury. Traditionally, this has been performed by trained practitioners using a nonimage-guided percutaneous technique at the bedside. Recent literature suggests an expanding role for radiologists in obtaining biopsies using an ultrasound (US)-guided technique. The present study was undertaken study to determine if the two techniques produced liver biopsy specimens of similar quality and hypothesized that at our institution, non-US-guided percutaneous liver biopsies for HCV would be of higher quality than US-guided specimens.METHODS: Liver biopsies from 100 patients with chronic HCV infection (50 consecutive US-guided and 50 consecutive non-US-guided), were retrospectively identified using a hospital histopathology database. All original biopsy slides were coded and prospectively reanalyzed by a single hepatopathologist who was blinded to the technique used in obtaining the biopsy. Additionally, all liver biopsies for chronic HCV infection completed at the centre from 1998 to 2007 were identified and the technique used was recorded. Biopsy quality was determined primarily by the number of complete portal tracts (CPTs) identifiable in the slides. The total length of specimen and the degree of fragmentation were secondary outcome measures.RESULTS: There was a slight difference observed between the US-guided and non-US-guided groups in mean age (46.3 years versus 42.5 years, repectively; P=0.018) but no differences in sex, presence of cirrhosis, bilirubin, creatinine, international normalized ratio, and grade or stage of disease. Biopsies obtained using the US-guided technique produced higher quality specimens than the non-US-guided technique based on our primary outcome of number of CPTs in the biopsy (11.8 versus 7.4; P<0.001). US-guided specimens also were longer (24.4 mm versus 19.7 mm; P=0.001), had less fragmentation (P=0.016), and a higher overall histopathological quality assessment (P=0.026) than the non-US-guided biopsies. However, there was no significant difference between the two groups in the ability to grade and stage the disease (96% US-guided versus 90% in non-US-guided (P=0.20). Over a 10-year period, 763 biopsies for chronic HCV infection were identified with an obvious trend toward the increased use of US-guided technique observed at 2% in 1998 to 85% in 2007.CONCLUSIONS: US-guided liver biopsies for chronic HCV are the most common method of obtaining specimens at the Kingston General Hospital, Kingston, Ontario, and are of higher quality than non-US-guided specimens. However, there is no significant difference in the two techniques in the ability to grade and stage chronic HCV.

scholarly journals Percutaneous Liver Biopsy Practice Patterns Among Canadian Hepatologists

2013 ◽  
Vol 27 (11) ◽  
pp. e31-e34 ◽  
Author(s):  
Mohammed Aljawad ◽  
Eric M Yoshida ◽  
Julia Uhanova ◽  
Paul Marotta ◽  
Natasha Chandok
Keyword(s):  
Liver Biopsy ◽  
Patient Preference ◽  
Practice Patterns ◽  
Standard Procedure ◽  
Percutaneous Liver Biopsy ◽  
Equal Frequency ◽  
The Past ◽  
Perception Of Safety ◽  
Liver Biopsies ◽  
Ambulatory Procedure

BACKGROUND: Percutaneous liver biopsy (PLB) is the standard procedure to obtain histological samples essential for the management of various liver diseases. While safe, many hepatologists no longer perform their own PLBs; the reasons for this practice shift are unknown.OBJECTIVE: To describe the attitudes, practice patterns and barriers to PLB among hepatologists in Canada.METHODS: A survey was distributed to all hepatologists in Canada.RESULTS: Thirty-two of 40 (80%) hepatologists completed the survey; the majority of respondents were male (72%) and had been in practice for >5 years in an academic setting. Fifty-six per cent of hepatologists referred all PLBs to radiology, and only 19% of hepatologists reported performing their own PLBs most or all of the time. There were no sex differences nor were there differences based on years in practice. Fifty per cent of respondents who performed PLB routinely used ultrasound, and PLBs are performed in equal frequency in an ambulatory procedure area (50%) versus the endoscopy suite (36%). For almost one-half of hepatologists (47%), their performance of PLBs decreased in the past five years. The majority of respondents at an academic centre (75%) reported access to FibroScan (Echosens, France), and most estimated a resultant 25% to 50% reduction in the need for PLBs. Lack of resources, patient preference and suboptimal reimbursement were the most common reasons cited for not performing PLBs.CONCLUSION: Most hepatologists in Canada do not perform PLBs to the extent that they did in the past, but refer to radiology. The reasons for this shift in practice include lack of resources, improved perception of safety and patient preference. Where available, FibroScan resulted in a perceived 25% to 50% reduction in required liver biopsies.

scholarly journals Liver Biopsy in Children in Dhaka Shishu Hospital A Study of 30 Cases

1970 ◽  
Vol 34 (1) ◽  
pp. 1-6
Author(s):  
Md Jahangir Alam ◽  
Reaz Mobarak ◽  
Samsul Arefin ◽  
Nihar Ranjan Sarker ◽  
MD Abu Tayab ◽  
...  
Keyword(s):  
Liver Biopsy ◽  
Liver Diseases ◽  
Storage Disease ◽  
Biliary Cirrhosis ◽  
Percutaneous Liver Biopsy ◽  
Eligibility Criteria ◽  
Biopsy Material ◽  
Established Procedure ◽  
Major Complications ◽  
Clinical Diagnoses

Background: Liver biopsy is an established procedure to diagnose disease, to assessprognosis and to follow up of liver diseases. Although liver biopsy is a confirmatory diagnosticprocedure of majority of the hepatological disorders, it carries the risk of complications.Though major complications rarely occur, minor complications are common. To minimizecomplications, several biopsy techniques have been developed. The present study wasintended to correlate the clinical diagnoses with histological diagnoses and to observethe complications encountered by the children with percutaneous liver biopsy procedure.Patients and Methods: A total of 30 paediatric patients of suspected liver diseases,based on predefined eligibility criteria, were subjected to biopsy for confirmation ofdiagnosis. An ultrasound of liver was routinely performed before the procedure to markthe site for percutaneous biopsy. The field was prepared with alcohol-based solution(povidone-iodine) and sterile drapes were placed over the patient. Local anaestheticwas administered with 2% lidocain solution 20mg/ml (preferably levobupivacaine 2.5mg/ml) in both superficial and deep planes. A blind liver biopsy was done at the point ofmaximum dullness by percussion over the right trunk. We used cutting needle. Thediameter of the needle used in our study was 14-gauge (1.4 mm) which allowed adequatecollection of tissue for diagnosis. The biopsy material was taken in a very small amountof sterile normal saline and was immediately sent to the laboratory for evaluation.Results: Half (50%) of the patients was more than 5 years of age with median agebeing 5.0±3.9 years. Majority (80%) was male. Ninety percent of the patients belongedto poor socioeconomic class. Clinically the cases were diagnosed as having chronichepatitis (23.3%) followed by CLD (16.7%), isolated hepatomegaly (16.7%), livercirrhosis (13.3%) and storage disease (13.3%). Hepatosplenomegaly and congenitalhepatic fibrosis, each was 6.7%. Histological diagnoses of biopsy material obtainedfrom the liver confirmed that one-sixth (16.7%) of the cases had liver cirrhosis. Storagedisease and glycogen storage disease each comprised 13.3% of the cases andcongenital biliary atresia 10%. Very few cases had moderate fatty changes withcholestasis, congenital hepatic fibrosis, chronic inflammatory cells, chronic viralhepatitis and secondary biliary cirrhosis. Nearly half (46.7%) patients had mild painand discomfort at the site of biopsy, most of which spontaneously went away. However,some 3 (10%) patients developed major complications needing management.Conclusion: Liver biopsy is a well established procedure in the diagnosis and follow upof liver diseases. But it is not without risk of complications. So, before deciding for aliver biopsy, the indications and risks must be assessed cautiously for each patient.Key words: Percutaneous liver biopsy; clinical diagnoses; histological diagnoses; complications.DOI: 10.3329/bjch.v34i1.5694Bangladesh Journal of Child Health 2010; Vol.34(1): 1-6

scholarly journals S1126 Diagnostic Yield of Endoscopic Ultrasound-Guided Liver Biopsy in Comparison to Percutaneous Liver Biopsy: A Two Center Experience

2021 ◽  
Vol 116 (1) ◽  
pp. S529-S530
Author(s):  
Daryl Ramai ◽  
Antonio Facciorusso ◽  
Maria Bellocchi ◽  
Laura Bernardoni ◽  
Erminia Manfrin ◽  
...  
Keyword(s):  
Liver Biopsy ◽  
Endoscopic Ultrasound ◽  
Diagnostic Yield ◽  
Percutaneous Liver Biopsy ◽  
Ultrasound Guided

scholarly journals Two Birds with One Stone

2021 ◽  
Vol 2 (2) ◽  
pp. 50-51
Author(s):  
Payal Saxena
Keyword(s):  
Liver Biopsy ◽  
Liver Diseases ◽  
Diagnostic Methods ◽  
Patient Comfort ◽  
Pressure Measurements ◽  
Ultrasound Guided ◽  
Effective Technique ◽  
Portal Vein Pressure ◽  
Liver Biopsies ◽  
Lower Endoscopy

Despite improved serological and imaging diagnostic methods, liver biopsy remains an essential tool in diagnosing, evaluating and managing liver diseases. Endoscopic ultrasound-guided liver biopsy (EUS-LB) has been demonstrated to be a safe, feasible and effective technique with at least comparable or even better samples than transjugular or percutaneous liver biopsies.1-3 EUS-LB has various advantages: better patient comfort, if needed portal vein pressure measurements can be conducted simultaneously and different regions in the liver can be easily sampled. Moreover, as demonstrated in this case, EUS-LB can be performed concomitantly with an upper, lower endoscopy or EUS.

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