[Ultrasound-guided puncture-biopsy of the liver could replace blind puncture-biopsy in diffuse hepatopathies. Retrospective study of 1293 patients].
OBJECTIVE
The aim of this retrospective study was to compare the efficiency and complications of percutaneous hepatic biopsy either guided by ultrasonography in the left lobe, or blindly by the intercostal route in the right lobe, in the diagnosis of diffuse liver diseases.


METHODS
Liver biopsy was performed in 1,293 patients for 5 years. In group 1 (289 patients, including 140 out-patients), liver biopsy was guided by ultrasound. In group 2, blind intercostal liver biopsy was performed in 1,004 patients. Patients were observed for 6 hours after biopsy in both groups.


RESULTS
The failure rate of liver biopsy was significantly lower in group 1 (1.7%) than in group 2 (9.25%, P < 0.01). The prevalence of the histological lesions was similar in both groups. No related-biopsy death occurred. Complications were more serious after blind biopsy (1 acute pancreatitis with a hematoma of the liver, 1 bile leakage around the gallbladder, 1 hemoperitonitis, 1 large intrahepatic hematoma), than after guided biopsy (1 small hematoma of the liver, 1 acute biliary pain on the 10th day).


CONCLUSIONS
Hepatic biopsy guided by ultrasonography could replace blind biopsy in the diagnosis of diffuse liver diseases.
Service d'Hépato-Gastroentérologie, CHU-Hôpital Nord, Amiens.
J P
JP
Joly
S
S
Khouani
C
C
Decrombecque
A
A
Razafimahaleo
H
H
Sevestre
J P
JP
Capron
D001707:Biopsy, Needle / Q000009:adverse effects / Q000379:methods*; D002908:Chronic Disease; D005260:Female; D006505:Hepatitis / Q000000981:diagnostic imaging* / Q000473:pathology; D006519:Hepatitis, Alcoholic / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D014463:Ultrasonography
La ponction-biopsie hépatique échoguidée pourrait remplacer la ponction-biopsie à l'aveugle dans les hépatopathies diffuses. Une étude rétrospective chez 1,293 patients.