[Spectrum and bleeding complications of sonographically guided interventions of the liver and pancreas].
OBJECTIVE
Sonographically guided fine-needle punctures (p.) are considered to be a low risk procedure. Interventions with needles with a larger diameter seem to cause more complications. In search of potential complications, we examined 1923 sonographically guided interventions of the liver and pancreas in a retrospective analysis.


METHODS
We examined the coherence of the kind of intervention and complications. We considered bleeding with a need for transfusion and/or a need for surgical treatment as complications. Diseases and medication increasing the probability of post-interventional bleeding were also detected.


RESULTS
1923 sonographically guided interventions in the abdomen (1800 in the liver, 123 in the pancreas) were analyzed (n = 1696 diagnostic interventions, n = 227 therapeutic interventions). Needles with diameters > 1 mm were primarily used. Drainage and radiofrequency ablation (RFA) (12 % of all interventions) were performed with devices with diameters between 2 - 3.96 mm. A need for transfusion was found in 8 / 1923 patients (0.4 %), predominantly in the first 24 h. There was no significant correlation between coagulation preventing drugs (heparin, NSAIDs, antiaggregants) and bleeding events. Patients who suffered from liver cirrhosis with a thromboplastin time of < 50 % had a higher risk of post-interventional bleeding than patients with liver cirrhosis and a thromboplastin time > 50 %. Furthermore, therapeutic interventions showed higher complication rates than diagnostic procedures.


CONCLUSIONS
Severe bleeding complications with a need for transfusion in sonographically guided procedures are rare (0.4 %). Our results showed that liver cirrhosis with a low thromboplastin time (< 50 %) seems to be the most important risk factor for patients. Overall, sonographically guided interventions are safe and have low complication rates considering careful performance and contraindications.
Frieser
M
M
Medizinische Klinik 1, NOZ, Universität Erlangen-Nürnberg, Ulmenweg 18, Erlangen. markus.frieser@uk-erlangen.de
Lindner
A
A
Meyer
S
S
Westerteicher
M
M
Hänsler
J
J
Haendl
T
T
Hahn
E G
EG
Strobel
D
D
Bernatik
T
T
D044963:Biopsy, Fine-Needle / Q000009:adverse effects* / Q000295:instrumentation; D017115:Catheter Ablation; D003560:Cysts / Q000000981:diagnostic imaging / Q000473:pathology; D004322:Drainage / Q000009:adverse effects* / Q000295:instrumentation; D004867:Equipment Design; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology*; D008103:Liver Cirrhosis / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary; D010179:Pancreas / Q000000981:diagnostic imaging* / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D010314:Partial Thromboplastin Time; D010949:Plasma; D017713:Platelet Transfusion; D019106:Postoperative Hemorrhage / Q000209:etiology* / Q000401:mortality; D011517:Prothrombin Time; D011677:Punctures / Q000009:adverse effects* / Q000295:instrumentation; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D018084:Ultrasonography, Interventional / Q000009:adverse effects*