[Practices of transcutaneous liver biopsies in France. Results of a retrospective nationwide study].
OBJECTIVE
Few nationwide studies have evaluated the number of transcutaneous liver biopsies performed for diffuse parenchymal liver diseases and the practices of this procedure. The aims of this retrospective nationwide survey were to precise these data.


METHODS
In 1997, a confidential questionnaire was mailed to all AFEF and ANGH members. Parameters studied were annual number of transcutaneous liver biopsies performed by center for diffuse parenchymal liver diseases, sedation and/or premedication, haemostasis parameters required for choosing transcutaneous liver biopsy route, fasting liver biopsy, use of venous access, ultrasonography use during liver biopsy (determination of puncture site), modalities of follow-up after liver biopsy, number of biopsies performed as day-care procedure.


RESULTS
Sixty seven centers were involved in the study. About 12 000 transcutaneous liver biopsies are performed each year in France for diffuse liver parenchymal diseases. Mean number of biopsies per center is 130 (median 70, ranges 5-600). Sedation is routinely used before liver biopsy in 31% of centers; APTT is not measured in 20% of centers and bleeding time is measured in 30% of centers before liver biopsy. Ultrasonography for determination of puncture site is used in 41% of centers. Venous access is implemented in 36% of centers. Outpatient liver biopsies are performed in less than 15% of cases by 64% of centers whereas 30% of centers practice outpatient liver biopsy of more than 50% of cases. Heterogeneity of biopsy practices are related to individual choices rather than the type or location of medical practice.


CONCLUSIONS
Many transcutaneous liver biopsies are performed each year in France for diffuse parenchymal liver diseases, and practices vary greatly. Ultrasonography use and outpatient liver biopsy should be developed.
Unité d'Hépatologie, Centre Hospitalier Laennec, Creil.
J F
JF
Cadranel
P
P
Rufat
F
F
Degos
D000553:Ambulatory Care; D001707:Biopsy, Needle / Q000379:methods* / Q000706:statistics & numerical data*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D008099:Liver / Q000473:pathology*; D008107:Liver Diseases / Q000473:pathology*; D010314:Partial Thromboplastin Time; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014463:Ultrasonography
D006993:Hypnotics and Sedatives