Digestive Diseases and Sciences

, Volume 46, Issue 1, pp 128–132

Percutaneous Liver Biopsy Using an Ultrasound-Guided Subcostal Route

Authors

  • Piero Rossi
    • Department of General Surgery, and “Clinica Columbus,”University of Rome “Tor Vergata,”
  • Pierpaolo Sileri
    • Department of General Surgery, and “Clinica Columbus,”University of Rome “Tor Vergata,”
  • Paolo Gentileschi
    • Department of General Surgery, and “Clinica Columbus,”University of Rome “Tor Vergata,”
  • Giuseppe S. Sica
    • Department of General Surgery, and “Clinica Columbus,”University of Rome “Tor Vergata,”
  • Antonio Forlini
    • Department of General Surgery, and “Clinica Columbus,”University of Rome “Tor Vergata,”
  • Vito M. Stolfi
    • Department of General Surgery, and “Clinica Columbus,”University of Rome “Tor Vergata,”
  • Adriano De Majo
    • Department of General Surgery, and “Clinica Columbus,”University of Rome “Tor Vergata,”
  • Giorgio Coscarella
    • Department of General Surgery, and “Clinica Columbus,”University of Rome “Tor Vergata,”
  • Silvia Canale
    • Department of General Surgery, and “Clinica Columbus,”University of Rome “Tor Vergata,”
  • Achille L. Gaspari
    • Department of General Surgery, and “Clinica Columbus,”University of Rome “Tor Vergata,”
Article

DOI: 10.1023/A:1005571904713

Cite this article as:
Rossi, P., Sileri, P., Gentileschi, P. et al. Dig Dis Sci (2001) 46: 128. doi:10.1023/A:1005571904713

Abstract

Percutaneous biopsy is considered one of the most important diagnostic tools to evaluate diffuse liver diseases. The introduction and widespread diffusion of ultrasounds in medical practice has improved percutaneous bioptic technique, while reducing postoperative complications. Although ultrasonography has become almost ubiquitous in prebiopsy investigation, only one third of biopsies are performed under ultrasound control. Moreover, the one-day procedure, reported in several studies to be safe and cost effective, accounted for only 4% of biopsies done. We report our experience of 142 percutaneous US-guided biopsies performed on 140 patients affected by chronic diffuse liver disease over a four-year period. Liver biopsies were performed under US guidance at the patient's bed using an anterior subcostal route. We evaluated postoperative pain, modifications of blood pressure and red cell count, hospital stay, morbidity and mortality rates, and adequacy of specimens for histologic examination. There was no operative mortality. As for major complications, one case of hemobilia occurred. As for minor complications, two cases of persistent postoperative pain required analgesic therapy. Patients were discharged the day following the procedure in all cases but two, who were discharged on the third and fifth postoperative days. Liver specimens were suitable for histologic diagnosis in all but one case, in which there were no portal spaces. According to our experience, we believe that hepatic biopsy guided by ultrasonography could replace blinded biopsy in the diagnosis of diffuse liver disease. The procedure is suitable to be performed safely on an outpatient basis.

liverbiopsyultrasonographysafety

Copyright information

© Plenum Publishing Corporation 2001