Laparoscopically assisted liver biopsy with a hemostatic plug

Abstract

Background

Percutaneous and open liver biopsies are routine procedures for diagnosing liver pathology. However, the procedure can carry significant morbidity and even mortality, especially in the event of an uncorrectable coagulopathy or a highly vascular tumor.

Methods

A technique described for use in such circumstances involves laparoscopy for identification of the lesion to be biopsied, enables placement of a gelatin hemostatic plug in the core biopsy tract, and confirms hemostasis after percutaneous plugging of the biopsy site.

Results

The technique was successfully used for seven patients: six patients with hepatic coagulopathy and one with a highly vascular liver tumor. There were no complications during either the intra- or postoperative period. The patients experienced minimal postoperative discomfort and returned to baseline activity on the first postoperative day.

Conclusion

The authors believe that the described technique of biopsy site plugging offers a safe alternative for liver biopsy among patients with an uncorrectable coagulopathy and those requiring a biopsy before correction of the bleeding disorder.