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

Abstract

BACKGROUND: Though strongly suggestive of metastasis, focal lesions on liver scans of oncological patients require histological confirmation for the prescription of adequate treatment. OBJECTIVE: To evaluate the safety and efficacy of US-guided percutaneous core liver biopsy. METHODS: Descriptive, cross-sectional study based on secondary data from 171 patients submitted to US-guided percutaneous core liver biopsy at the diagnostic radiology service of the Ceará Cancer Institute (ICC, Brazil) between February 2010 and March 2015. Quantitative data were expressed in absolute numbers or percentages, with emphasis on the rate of complications observed within six hours after the procedure. RESULTS: The overall accuracy was 96.4%. The overall rate of complications was 2.3%, three quarters of which was due to hemorrhage. Age over 50 years was positively associated with accuracy. No deaths occurred within the period of observation. CONCLUSION: Our findings support the claim that the use of thick biopsy needles improves diagnostic accuracy. The few complications observed were non-lethal and predominantly hemorrhagic.

Outpatient Percutaneous Liver Biopsy is a Low-risk Procedure and has Steatosis as a New Indication Trend

“…It has already been described that patients older than 50 years are more likely to progress with bleeding 25,26 , but no statistical association between age and hemorrhage was found in our study. Parente et al 8 reported a higher rate of bleeding after liver biopsies (2.3%); however, the studied population had neoplasia, which is more susceptible to hemorrhage. A higher risk of bleeding is also expected in patients with platelets count < 50,000-70,000/mm³ and/or INR > 1.3-1.5 3,10,[25][26][27] .…”

“…In our study, the incidence of low blood pressure following the PLB was low (1.5%), similar to previous reports 7,20 . It may occur due to bleeding, vasovagal reflex associated with pain, or even as a side effect of sedative drugs, such as midazolam 4,7,8 . We did not find an association between low blood pressure and bleeding or pain, possibly due to the low frequency of such complications in our sample.…”

“…Although the pain has been commonly reported after PLB (30 -50%), it is usually mild, self-limited, or has a good response to analgesics 4,7 . The incidence of serious complications is low, not exceeding 6% 8,9 .…”

Clinical application of ultrasonography-guided percutaneous liver biopsy and its safety over 18 years

“…It is widely used to maximize the effectiveness of the procedure and minimize the complication rate. 5 Recently, many noninvasive methods have been developed to replace liver biopsies. 6 The most widely used noninvasive test is transient elastography.…”

“…Currently, image-guided liver biopsies have replaced traditional blind liver biopsies. It is widely used to maximize the effectiveness of the procedure and minimize the complication rate [ 5 ].…”