Single-pass percutaneous liver biopsy for diffuse liver disease using an automated device: experience in 154 procedures.
OBJECTIVE
To describe our experience with ultrasound (US)-guided percutaneous liver biopsies using the INRAD 18 G Express core needle biopsy system.


METHODS
One hundred and fifty-four consecutive percutaneous core liver biopsy procedures were performed in 153 men in a single institution over 37 months. The medical charts, pathology reports, and radiology files were retrospectively reviewed. The number of needle passes, type of guidance, change in hematocrit level, and adequacy of specimens for histologic analysis were evaluated.


RESULTS
All biopsies were performed for histologic staging of chronic liver diseases. The majority of patients had hepatitis C (134/153, 90.2%). All patients were discharged to home after 4 hr of post-procedural observation. In 145 of 154 (94%) biopsies, a single needle pass was sufficient for diagnosis. US guidance was utilized in all but one of the procedures (153/154, 99.4%). The mean hematocrit decrease was 1.2% (44.1--42.9%). Pain requiring narcotic analgesia, the most frequent complication, occurred in 28 of 154 procedures (18.2%). No major complications occurred. The specimens were diagnostic in 152 of 154 procedures (98.7%).


CONCLUSIONS
Single-pass percutaneous US-guided liver biopsy with the INRAD 18 G Express core needle biopsy system is safe and provides definitive pathologic diagnosis of chronic liver disease. It can be performed on an outpatient basis. Routine post-biopsy monitoring of hematocrit level in stable, asymptomatic patients is probably not warranted.
Rivera-Sanfeliz
Gerant
G
Department of Radiology, UCSD Medical Center, 200 West Arbor Drive, San Diego, CA 92103, USA. gerantrivera@ucsd.edu
Kinney
Thomas B
TB
Rose
Steven C
SC
Agha
Ayad K M
AK
Valji
Karim
K
Miller
Franklin J
FJ
Roberts
Anne C
AC
D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D004867:Equipment Design; D004869:Equipment Safety; D005471:Fluoroscopy; D006801:Humans; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional