Fibrin-glue-sealed liver biopsy: indications, complications and results

Martín-Mateos, Rosa María; Román, Antonio López-San; García-Sánchez, Concepción; García-Hoz, F; Gil-Grande, L; Gómez, Elena Muñoz; García-González, Miguel A.

doi:10.15403/jgld-1289

Cited by 4 publications

(10 citation statements)

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“…Five studies compared the diagnostic outcome and safety between PLB (n = 529) and TJLB (n = 336) (8,17,18,22,24). Among the included studies, five were of high quality (8,12,13,15,24), seven were of medium quality (14,16,18,20,23,25,27), and five were of low quality (17,19,21,22,26) (Supplementary Table 1).…”

Section: Resultsmentioning

confidence: 99%

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Diagnostic outcome and safety of plugged liver biopsy in high-risk patients: a systematic review and meta-analysis

et al. 2023

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Background Percutaneous liver biopsy is the gold standard test for the assessment of liver disease. In patients with coagulopathy, ascites, post-transplantation, and hypervascular tumors, biopsy is associated with increased risk of adverse events (AEs). Transjugular liver biopsy (TJLB) is recommended in these conditions but is expensive and unavailable at many centers. Plugged liver biopsy (PLB) provides an alternate diagnostic modality in these high-risk cases. Purpose To analyze the pooled diagnostic outcome and safety of PLB in high-risk cases. Material and Methods A literature search of various databases from January 1990 to July 2022 was conducted for studies evaluating the outcome of PLB in high-risk cases. The primary outcomes were pooled sample adequacy and AEs. Pooled event rates across studies were expressed with summative statistics. Results A total of 17 studies (2329 patients) were included in the meta-analysis. The pooled proportion of sample adequacy was 98.9% (95% confidence interval [CI]=98.2–99.6). Severe AEs, major bleeding, and minor AEs were seen in 0.7% (95% CI=0.1–1.3), 0.4% (95% CI=0.1–0.8), and 11.5% (95% CI=2.4–20.6) of the patients. There was only one reported mortality, giving a pooled incidence of 0.0002% (95% CI=0.0–0.0038). Compared to TJLB (5 studies, n = 336), there was no difference in either sample adequacy (odds ratio [OR]=2.34, 95% CI=0.83–6.58) or risk of serious AEs (OR=0.47, 95% CI=0.173–1.31). Conclusion PLB can be safely performed on patients with coagulopathy and/or ascites with high sample adequacy rates and low incidence of AEs and mortality.

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Section: Resultsmentioning

confidence: 99%

“…Acquisition of adequate samples with plugged liver biopsy was reported in 13 studies with 982 patients (12–15,17–22,24,27). The pooled proportion of sample adequacy was 98.9% (95% CI = 98.2–99.6; I 2 = 0.0%) (Fig.…”

Section: Resultsmentioning

confidence: 99%

Diagnostic outcome and safety of plugged liver biopsy in high-risk patients: a systematic review and meta-analysis

et al. 2023

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“…Interest in the use of biological adhesives has increased since the creation of Dermabond ® , which is a cyanoacrylate that is specially designed for clinical use and was approved by the Food and Drug Administration (FDA) in 1998. A variety of biological sealants and adhesives have been applied to control bleeding in cases of hepatic injuries [1][2][3] and different endoscopic biopsies of solid organs [4,5]. The liver has a remarkably ability to self-repair and regenerate following an injury [6].…”

Section: Introductionmentioning

confidence: 99%

Tracking the Healing Process of Experimental Liver Injuries Treated with Different Sealants and Adhesive Biomaterials: An Evaluation of Matrix Metalloproteinase

Lloris‐Carsí¹,

Barrios²,

Lloris-Cejalvo³

et al. 2018

Preprint

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This study examines the matrix metalloproteinase (MMP) activity in the healing of liver injuries treated with biological adhesives Tachosil® and GelitaSpon® and the elastic cyanoacrylate Adhflex®. Hepatic lesions were induced in male rats using a Stiefel biopsy punch. Healing was assessed 2, 6, and 18 days after injury by quantifying tissue levels of MMP1, 2, 8, 9, and 13. Histopathological repair was evaluated using hematoxylin-eosin, Masson’s trichrome, and Periodic Acid Schiff (PAS) staining and immunohistochemical markers CD31 and CD68. The sealants contributed to complete healing. Histopathology and MMP findings indicate that Adhflex® has slower degradation and a strong inflammatory reaction at the onset of healing. Early on, all MMPs showed higher levels in Adhflex® and Tachosil®-treated animals, and MMP2 and MMP9 expressions were significantly higher in the Adhflex-treated group at 18 days post-injury (T3). The Adhflex® group had significantly higher MMP8 and MPP13 levels than other treated groups and showed a sustained overexpression of all MMPs, even in the latest healing stages. Notably, the overexpression did not negatively influence the histological healing process. All hepatic trauma injuries should be treated as emergencies, and any easy-to-use and rapid sealant like Adhflex® could be considered as an option for treating liver trauma.

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“…A variety of biological sealants and adhesives have been applied to control bleeding in cases of hepatic injuries [1, 2,3] and different endoscopic biopsies of solid organs. [4,5] The liver possesses a remarkable ability to self-repair and regenerate after injury [6]. Liver injury and regeneration have both been linked to complex extracellular matrix (ECM)-related pathways.…”

Section: Introductionmentioning

confidence: 99%

Tracking Healing Process of Experimental Liver Injuries Treated with Different Sealants and Adhesives Biomaterials. Matrix Metalloproteinase Evaluation

Lloris‐Carsí¹,

Barrios²,

Lloris-Cejalvo³

et al. 2018

Preprint

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Sealants and adhesives are used in the repair and preservation of damaged solid organs. This study examines the matrix metalloproteinases (MMP) activity in the healing of liver injuries treated with two biological adhesives (Tachosil® and GelitaSpon®) as well as that of a new elastic cyanoacrylate (Adhflex®). Methods. We induced in 90 male rats hepatic lesions using a Stiefel biopsy punch in the liver. Wound healing was assessed 2, 6, and 18 days after injury by quantifying MMP1, 2, 8, 9, and 13 tissue levels. The histopathological repair was evaluated by hematoxylin-eosin, Masson’s trichrome, and Periodic Acid Schiff (PAS) staining and CD31, CD68 immunohistochemical marker. The three sealants used supported complete healing of liver lesions. Both histopathology and MMP findings indicate that the degradation process of Adhflex® is slower and produces a strong inflammatory reaction at the beginning of healing. Results. All the MMPs measured disclosed higher values at an early stage of the healing process in animals treated with Adhflex® and Tachosil, the expression of for MMP2 and MMP9 being significantly higher in the Adhflex-treated group. Animals treated with Tachosil had significant higher values of MMP8 and MPP13 than the Adhflex-treated group. Animals treated with Adhflex® showed a maintained overexpression in all the MMPs tested even at the latest wound healing stages. Conclusion. Notably, this MMPs overexpression did not negatively influence the histological healing process of hepatic injuries. Given that all hepatic trauma injuries should be considered emergencies, any easy-to-use and rapid sealant, such as Adhflex®, could be considered a suitable treatment option.

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Fibrin-glue-sealed liver biopsy: indications, complications and results

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Cited by 4 publications

References 0 publications

Diagnostic outcome and safety of plugged liver biopsy in high-risk patients: a systematic review and meta-analysis

Diagnostic outcome and safety of plugged liver biopsy in high-risk patients: a systematic review and meta-analysis

Tracking the Healing Process of Experimental Liver Injuries Treated with Different Sealants and Adhesive Biomaterials: An Evaluation of Matrix Metalloproteinase

Tracking Healing Process of Experimental Liver Injuries Treated with Different Sealants and Adhesives Biomaterials. Matrix Metalloproteinase Evaluation

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