Experiência em pacientes com suspeita de hepatopatia crônica e contra-indicação para biópsia hepática percutânea utilizando a agulha de Ross modificada

Abstract

Transjugular liver biopsy is useful for the histopathologic diagnosis of patients with chronic liver diseases whenever the percutaneous route is contraindicated. In this series we obtained histopathologic diagnosis for 64.1% of the subjects studied. Patients suspected of having cirrhosis had a low yield of histopathologic diagnosis (50%) when compared to subjects without clinical evidence for cirrhosis (78.9%). The technique is rather complex, and can cause serious complications. This, it should be performed in reference centers in radiology and hepatology.

Transjugular liver biopsy: histological diagnosis success comparing the trucut to the modified aspiration Ross needle

“…BRUZZI et al (6) obtained 10.4 portal triads with the trucut models (range -6 to 20). In the present series, a mean of 3.5 portal triads was obtained with the modified Ross needle (range -1 to 12) (24) , and 8.8 with the automated trucut needle (range -1 to 21) (P < 0.001, Student's t test).…”

“…They had at least one of the following contraindications to percutaneous liver biopsy: coagulopathy (prothrombin time less than 60% of control, platelet count less than 60000/mm 3 ), massive ascites (tense abdominal wall with ultrasonography confirmed ascites and non responsive to diuretics), anemia associated to chronic renal failure (hematocrit lower than 29%) in individuals on hemodialysis receiving heparin on a every other day schedule and morbid obesity (body weight greater than 20% of ideal body weight) (24) .…”

“…The objective of the present study was to assess the yield of histological diagnosis obtained on TJLB using an automated trucut needle and comparing it to a historical series obtained with a modified Ross aspiration needle and our institution published elsewhere (24) .…”

Us-Guided Percutaneous Core Liver Biopsy: Analysis of 171 Cases From a Single Oncology Service

“…There are, however, also contraindications for percutaneous core biopsy. According to some authors (4,5) , these include: A) Coagulation disturbance (confirmed by the presence of one or more of the following: prothrombin time <60% of control, partial thromboplastin time 5 sec longer than control, and platelet count <60,000/mm³); B) Massive ascites (increased abdominal wall ten-sion, with echograhy-confirmed ascites refractory to treatment with diuretics); C) Accentuated chronic anemia associated with chronic kidney failure, hematocrit count ≤29%, and use of anticoagulants (heparin); D) Morbid obesity (20% above the ideal body weight).…”