title: Liver biopsy: Analysis of results of two specialist teams.
abstract: OBJECTIVE
  To analyze the safety and the adequacy of a sample of liver biopsies (LB) obtained by gastroenterologist (G) and interventional radiologist (IR) teams.
  
  
  METHODS
  Medical records of consecutive patients evaluated at our GI unit from 01/01/2004 to 31/12/2010 for whom LB was considered necessary to diagnose and/or stage liver disease, both in the setting of day hospital and regular admission (RA) care, were retrieved and the data entered in a database. Patients were divided into two groups: one undergoing an ultrasonography (US)-assisted procedure by the G team and one undergoing US-guided biopsy by the IR team. For the first group, an intercostal approach (US-assisted) and a Menghini modified type needle 16 G (length 90 mm) were used. The IR team used a subcostal approach (US-guided) and a semiautomatic modified Menghini type needle 18 G (length 150 mm). All the biopsies were evaluated for appropriateness according to the current guidelines. The number of portal tracts present in each biopsy was assessed by a revision performed by a single pathologist unaware of the previous pathology report. Clinical, laboratory and demographic patient characteristics, the adverse events rate and the diagnostic adequacy of LB were analyzed.
  
  
  RESULTS
  During the study period, 226 patients, 126 males (56%) and 100 females (44%), underwent LB: 167 (74%) were carried out by the G team, whereas 59 (26%) by the IR team. LB was mostly performed in a day hospital setting by the G team, while IR completed more procedures on inpatients (P < 0.0001). The groups did not differ in median age, body mass index (BMI), presence of comorbidities and coagulation parameters. Complications occurred in 26 patients (16 G team vs 10 IR team, P = 0.15). Most gross samples obtained were considered suitable for basal histological evaluation, with no difference among the two teams (96.4% G team vs 91.5% IR, P = 0.16). However, the samples obtained by the G team had a higher mean number of portal tracts (G team 9.5 ± 4.8; range 1-29 vs IR team 7.8 ± 4.1; range 1-20) (P = 0.0192) and a longer mean length (G team 22 mm ± 8.8 vs IR team 15 ± 6.5 mm) (P = 0.0001).
  
  
  CONCLUSIONS
  LB can be performed with similar outcomes both by G and IR. Use of larger dimension needles allows obtaining better samples, with a similar rate of adverse events.
authors.affiliation: Giulia Anania, Elia Gigante, Matteo Piciucchi, Flavia Baccini, Giulio Antonelli, Paola Begini, Gianfranco Delle Fave, Massimo Marignani, Department of Digestive and Liver Disease, School of Medicine and Psychology University "Sapienza", 00189 Rome, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Anania
authors.affiliation: Giulia Anania, Elia Gigante, Matteo Piciucchi, Flavia Baccini, Giulio Antonelli, Paola Begini, Gianfranco Delle Fave, Massimo Marignani, Department of Digestive and Liver Disease, School of Medicine and Psychology University "Sapienza", 00189 Rome, Italy.
authors.forename: Elia
authors.initials: E
authors.lastname: Gigante
authors.affiliation: Giulia Anania, Elia Gigante, Matteo Piciucchi, Flavia Baccini, Giulio Antonelli, Paola Begini, Gianfranco Delle Fave, Massimo Marignani, Department of Digestive and Liver Disease, School of Medicine and Psychology University "Sapienza", 00189 Rome, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Piciucchi
authors.affiliation: Giulia Anania, Elia Gigante, Matteo Piciucchi, Flavia Baccini, Giulio Antonelli, Paola Begini, Gianfranco Delle Fave, Massimo Marignani, Department of Digestive and Liver Disease, School of Medicine and Psychology University "Sapienza", 00189 Rome, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Pilozzi
authors.affiliation: Giulia Anania, Elia Gigante, Matteo Piciucchi, Flavia Baccini, Giulio Antonelli, Paola Begini, Gianfranco Delle Fave, Massimo Marignani, Department of Digestive and Liver Disease, School of Medicine and Psychology University "Sapienza", 00189 Rome, Italy.
authors.forename: Eugenio
authors.initials: E
authors.lastname: Pucci
authors.affiliation: Giulia Anania, Elia Gigante, Matteo Piciucchi, Flavia Baccini, Giulio Antonelli, Paola Begini, Gianfranco Delle Fave, Massimo Marignani, Department of Digestive and Liver Disease, School of Medicine and Psychology University "Sapienza", 00189 Rome, Italy.
authors.forename: Adriano Maria
authors.initials: AM
authors.lastname: Pellicelli
authors.affiliation: Giulia Anania, Elia Gigante, Matteo Piciucchi, Flavia Baccini, Giulio Antonelli, Paola Begini, Gianfranco Delle Fave, Massimo Marignani, Department of Digestive and Liver Disease, School of Medicine and Psychology University "Sapienza", 00189 Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Capotondi
authors.affiliation: Giulia Anania, Elia Gigante, Matteo Piciucchi, Flavia Baccini, Giulio Antonelli, Paola Begini, Gianfranco Delle Fave, Massimo Marignani, Department of Digestive and Liver Disease, School of Medicine and Psychology University "Sapienza", 00189 Rome, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Rossi
authors.affiliation: Giulia Anania, Elia Gigante, Matteo Piciucchi, Flavia Baccini, Giulio Antonelli, Paola Begini, Gianfranco Delle Fave, Massimo Marignani, Department of Digestive and Liver Disease, School of Medicine and Psychology University "Sapienza", 00189 Rome, Italy.
authors.forename: Flavia
authors.initials: F
authors.lastname: Baccini
authors.affiliation: Giulia Anania, Elia Gigante, Matteo Piciucchi, Flavia Baccini, Giulio Antonelli, Paola Begini, Gianfranco Delle Fave, Massimo Marignani, Department of Digestive and Liver Disease, School of Medicine and Psychology University "Sapienza", 00189 Rome, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Antonelli
authors.affiliation: Giulia Anania, Elia Gigante, Matteo Piciucchi, Flavia Baccini, Giulio Antonelli, Paola Begini, Gianfranco Delle Fave, Massimo Marignani, Department of Digestive and Liver Disease, School of Medicine and Psychology University "Sapienza", 00189 Rome, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Begini
authors.affiliation: Giulia Anania, Elia Gigante, Matteo Piciucchi, Flavia Baccini, Giulio Antonelli, Paola Begini, Gianfranco Delle Fave, Massimo Marignani, Department of Digestive and Liver Disease, School of Medicine and Psychology University "Sapienza", 00189 Rome, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Delle Fave
authors.affiliation: Giulia Anania, Elia Gigante, Matteo Piciucchi, Flavia Baccini, Giulio Antonelli, Paola Begini, Gianfranco Delle Fave, Massimo Marignani, Department of Digestive and Liver Disease, School of Medicine and Psychology University "Sapienza", 00189 Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Marignani
keywords: Liver biopsy; Menghini needle; Portal tracts.; Sample adequacy; Ultrasound-assisted biopsy; Ultrasound-guided biopsy