Videolaparoscopic management of percutaneous liver biopsy complications.
Percutaneous liver biopsy is a routine procedure in the diagnosis, management, and follow-up of several liver disorders. Mortality and morbidity rates from percutaneous liver biopsy are low. This report of three cases of serious percutaneous liver biopsy complication and their management highlights the role played by videolaparoscopy as a diagnostic and therapeutic procedure in two different types of PLB complication: hemobilia and bile peritonitis. In two patients, intrahepatic arteriobiliary fistula developed with gastrointestinal hemorrhage (hemobilia). Both were treated with cholecystectomy and ligation of the right branch of the hepatic artery. In the third case, the percutaneous liver biopsy needle punctured the gallbladder, leading to bile peritonitis and acute abdomen, and the patient underwent videolaparoscopic cholecystectomy with aspiration and lavage of the abdominal cavity. Videolaparoscopic procedures are an adequate alternative for the management of serious percutaneous liver biopsy complications such as hemobilia and bile peritonitis. The advantages of a videolaparoscopy include low morbidity rates, quick recovery, good cosmetic result, and ability to resolve the complications of percutaneous liver biopsy.
Gama-Odrigues
J
J
Department of Gastroenterology, University of São Paulo Medical School, Brazil. jagama@ruralsp.com.br
Bresciani
C
C
Seid
V E
VE
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000009:adverse effects*; D002763:Cholecystectomy; D005260:Female; D005704:Gallbladder / Q000293:injuries; D006431:Hemobilia / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology; D010535:Laparoscopy / Q000379:methods; D008107:Liver Diseases / Q000473:pathology*; D008297:Male; D010538:Peritonitis / Q000209:etiology* / Q000601:surgery; D014741:Video Recording