Die sonographisch assistierte Leberbiopsie - Ablösung der blinden Leberpunktion?^*

Abstract

Since the beginning of 1980 the authors have performed upper-abdominal ultrasound examination immediately preceding percutaneous needle biopsy (after Menghini), previously performed "blind". Knowledge of the particular liver topography made it possible to perform reliably punctures with only a small number of multiple punctures (6.4%) being required, suitable biopsies more often being obtained than under laporoscopic control. Compared with 354 consecutive blind liver biopsies, guided biopsy caused pain from the puncture in 1.9% (previously 5.9%), with a reduction of need for analgesics from 4.5% to 1.1%. The rate of more serious complications was reduced from five (1.4%) to one (0.2%), although as a result of ultrasound the indications for percutaneous liver biopsy were more frequent, since numerous "classical" contra-indications could be ignored. Blind liver biopsy should thus be abandoned for ultrasound-guided percutaneous puncture.

Modern Possibilities of Endosurgical Biopsy in Children with Chronic Liver Diseases

“…В 1976 г. J. Haaga и R. Alfidi впервые провели прицельную пункционную биопсию очагового поражения печени под контролем компьютерной томографии [13]. Пункция по Menghini при эхографическом ассистировании впервые проведена L. Greiner и F. Franken в 1983 г. и до настоя-щего времени считается методом выбора при получении биопсийного материала [14]. Диагностическая ценность транскутанной пункции оставалась бесспорной на про-тяжении последних десятилетий.…”