Literature DB >> 19184991

Safety and efficacy of sonographic-guided random real-time core needle biopsy of the liver.

Siddharth A Padia1, Mark E Baker, Christopher J Schaeffer, Erick M Remer, Nancy A Obuchowski, Charles Winans, Brian R Herts.   

Abstract

PURPOSE: To determine the safety and efficacy of real-time, sonographic-guided, random percutaneous needle biopsy of the liver in a tertiary medical center.
METHOD: From an IRB-approved biopsy database, all patients who had random liver biopsy performed over a 24-month period were selected. In 350 patients, 539 random percutaneous needle biopsies of the liver were performed under real-time sonographic visualization. The following were recorded from the electronic medical record: patient demographics, indication for biopsy procedure; radiologist's name; needle type and gauge and number of passes; use and amount of i.v. sedation or anesthesia; adequacy of the specimen; and complications following the procedure. RESULT: Of 539 biopsies, 378 (70%) biopsy procedures were performed on liver transplant recipients. Of the biopsy procedures in nontransplant patients, 81/161 (50%) concurrently underwent biopsy of a focal liver mass. An 18-gauge automated core biopsy needle was used in 536/539 (99%). Median number of passes per biopsy procedure was 1 (mean, 1.7; range, 1-6). Sedation using midazolam and fentanyl was used in 483/539 (90%). There were only 8 inadequate specimens (1.5%, [2.3, upper 95% confidence limit, fully described in Statistical Analysis]). Complications were identified in 11/539 biopsy procedures (2.0%, [2.6, upper 95% confidence limit]): 5 with severe postprocedural pain, 3 with symptomatic hemorrhage, 2 with infection, and 1 with a rash. There were no sedation-related complications and no deaths related to the procedure.
CONCLUSION: Real-time, sonographic-guided, random core-needle liver biopsy is a safe and highly effective procedure. 2009 Wiley Periodicals, Inc.

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Year:  2009        PMID: 19184991     DOI: 10.1002/jcu.20553

Source DB:  PubMed          Journal:  J Clin Ultrasound        ISSN: 0091-2751            Impact factor:   0.910


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