Indications, methods, and outcomes of percutaneous liver biopsy in England and Wales: an audit by the British Society of Gastroenterology and the Royal College of Physicians of London.

Gilmore, Ian; Burroughs, AK; Murray‐Lyon, Iain M.; Williams, Roger; Jenkins, David; Hopkins, A.

doi:10.1136/gut.36.3.437

Cited by 377 publications

(320 citation statements)

References 28 publications

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“…The major complication and main cause of postprocedural death is intraperitoneal bleeding. Substantial hemorrhage is described in 0.35%-0.5% of all liver biopsies, and subclinical bleeding occurs in up to 23% of patients (3,4,(7)(8)(9). In our study, none of the patients developed clinically important hemorrhage, a finding that may be attributed to our strict adherence to preestablished coagulation criteria, coupled with the experience of our operators.…”

Section: Discussionsupporting

confidence: 52%

Focal Hepatic Lesions: US-guided Biopsy—Lessons from Review of Cytologic and Pathologic Examination Results

Appelbaum

Kane²,

Kruskal³

et al. 2009

Radiology

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Purpose:To retrospectively assess factors affecting the success of ultrasonographically (US)-guided core liver biopsy of focal lesions on the basis of experience when both cytologic and pathologic examination results were available. Materials and Methods:This HIPAA-compliant retrospective study was granted an exemption from the institutional review board. Results:Biopsy specimens were diagnostic in 205 cases (98.6%) and were nondiagnostic in three cases (1.4%); 85.9% of the lesions were malignant. There was a single lesion in 89 patients (42.8%), and there were multiple lesions in 119 patients (57.2%). One biopsy pass was sufficient in 58 patients (27.9%); two passes were sufficient in 75 patients (36.1%); and three, four, five, and six passes were sufficient in 51 (24.5%), 17 (8.2%), five (2.4%), and two (1.0%) patients, respectively. There was no relationship between lesion size or location and the number of passes, according to the Pearson correlation and 2 test (P ϭ .16 and P ϭ .22, respectively). On average, 1.9 passes were required for metastatic lesions, versus 2.8 for nonmetastatic lesions (P Ͻ .001, Wilcoxon test). Cytologic and histopathologic findings were discordant in 25 cases (12.0%). Conclusion:The size and location of liver lesions sampled for biopsy do not influence the number of passes needed, while metastatic lesions require fewer passes. Without the on-site cytologic examination service, a predetermined number of three passes would be diagnostic in almost 90% of all cases.

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Section: Discussionsupporting

confidence: 52%

Focal Hepatic Lesions: US-guided Biopsy—Lessons from Review of Cytologic and Pathologic Examination Results

Appelbaum

Kane²,

Kruskal³

et al. 2009

Radiology

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“…In contrast, it was only 1.1% when performed by those who had conducted more than 100 biopsies (Gilmore, et al 1995).…”

Section: Complicationsmentioning

confidence: 88%

“…The overall reported complication rate varies significantly (Galati, et al 1994, Gilmore, et al 1995, Grant, et al 1999. These can range from minor complications such as pain and transient hypotension to major complications such as visceral perforation or significant bleeding which may lead to death.…”

Section: Complicationsmentioning

confidence: 99%

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Complications of Liver Biopsy

Subar¹,

Khan²,

O’Reilly³

2011

Liver Biopsy

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“…Unfortunately, it is invasive and associated with a small but definite morbidity and mortality [2][3][4][5]. Therefore, the use of non-invasive methods such as ultrasonography could be advantageous in LS assessment especially when frequent controls are necessary or in those situations where needle biopsy is contraindicated.…”

Section: Introductionmentioning

confidence: 99%

The prevalence of bright liver echo pattern in patients with chronic hepatitis C: correlation with steatosis and fibrosis

Loy¹,

Serra

Chessa

2014

J Ultrasound

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Purpose To evaluate the prevalence of bright liver echo pattern (BLP) on ultrasonography and its correlation with liver steatosis (LS), and fibrosis in patients with chronic hepatitis C. The usefulness of detecting skip areas for steatosis diagnosis has also been evaluated. Methods The study included 88 patients with chronic hepatitis C (55 men, 33 women, average age 45.7 ± 11.2 years). Ultrasound examination was performed in all patients before liver biopsy. The presence of BLP was assessed and graded from 1 to 3. Hypoechogenic areas (skip areas) around the gallbladder or near the portal vein were also evaluated. Hepatic fibrosis was assessed using the Ishak fibrosis score. Steatosis was graded as follows: 1, 2, 3 (\30, 30-70, [70 % of hepatocytes affected, respectively). Results Fifty-three of the 88 patients (60 %) showed BLP (40 grade 1, 13 grades 2 or 3). Skip areas were found in 14 patients (16 %). Histological steatosis was observed in 40 patients (45 %) and in 10 of them (25 %) was grades 2 and 3 (4 and 6 patients, respectively). As regards fibrosis, 2 patients showed F0, 34 F1, 28 F2, 20 F3, 4 F4, none of them F5 and F6. BLP of grades 2 or 3 and presence of skip areas were strongly correlated with LS (P = 0.00007 and P = 0.00003, respectively). No correlation was found between BLP and fibrosis. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of BLP for LS were 75, 50, 56, 68 and 61 %, respectively. When BLP of grades 2 and 3 and LS of 30 % or more were correlated, the sensitivity, specificity, PPV, NPV and accuracy of BLP were 72, 96, 61, 96 and 90 %, respectively. As regards skip areas the sensitivity, specificity, PPV, NPV and accuracy for LS were 35, 100, 100, 64 and 70 %, respectively. Conclusions In a well-defined group of patients with chronic hepatitis C, the detection of BLP grades 2 and 3 has a good sensitivity and high specificity for high grades of steatosis. A high specificity but low sensitivity for liver steatosis was also found for skip areas, whereas mild fibrosis does not seem to correlate with the hyperechogenicity of the liver.Keywords Liver steatosis Á Ultrasonography Á Bright liver echo pattern Á Skip areas Á Chronic hepatitis C Riassunto Scopo Scopo del lavoro é stato quello di valutare la prevalenza del ''bright liver echo pattern'' (BLP) all'ultrasonografia e la sua correlazione con la steatosi epatica (SE) e la fibrosi in un gruppo di pazienti con epatite cronica C. E' stata valutata anche l'utilità della determinazione delle cosiddette ''aree di risparmio'' per la diagnosi di steatosi. Metodi Lo studio ha incluso 88 pazienti con epatite cronica C (55 di sesso maschile, 33 di sesso femminile; età media 45.7 ± 11.2 anni). L'esame ultrasonografico é stato eseguito in tutti i pazienti prima di effettuare la biopsia epatica. La presenza di BLP é stata graduata da 1 a 3. É stata anche valutata la presenza o meno di aree ipoecogene (cosiddette ''aree di risparmio''), adiacenti alla colecisti o in sede parailare epatic...

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Indications, methods, and outcomes of percutaneous liver biopsy in England and Wales: an audit by the British Society of Gastroenterology and the Royal College of Physicians of London.

Cited by 377 publications

References 28 publications

Focal Hepatic Lesions: US-guided Biopsy—Lessons from Review of Cytologic and Pathologic Examination Results

Focal Hepatic Lesions: US-guided Biopsy—Lessons from Review of Cytologic and Pathologic Examination Results

Complications of Liver Biopsy

The prevalence of bright liver echo pattern in patients with chronic hepatitis C: correlation with steatosis and fibrosis

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