Are percutaneous transgastric biopsies using 14‐, 16‐ and 18‐G Tru‐Cut needles safe? An experimental study in the rabbit

Abstract

We evaluated perforation, peritonitis and bleeding after 14-, 16-, 18-G Tru-Cut needles were passed through the stomach in an animal model. Insertions were performed on seven anaesthetized rabbits with 18-, 16- and 14-G needles simulating the clinical technique. Diluted contrast medium with methylene blue (60 mL) was administered through a nasogastric tube after the biopsy. Computed tomography (CT) scanning of the upper abdomen was performed 10 min after the insertion for leakage. The abdominal contents were inspected by laparotomy. There was no contrast medium leakage outside the gastrointestinal tract on CT images. Neither methylene blue nor other stomach content leakage was identified by laparotomy, even with manual squeezing. A tiny spot of blood was observed on the serosal surface of the stomach with the 18-G needle passes (five cases), whereas a relatively large haematoma was present with 14-G needle (four cases). Six of the rabbits survived and one died due to an inadvertant aortic injury. The results of the study show that transgastric route with an 18-G cutting needle can be used without fear of peritonitis and bleeding.

Tru-cut needle biopsy: A novel approach in the diagnosis of solid oral pathologies

“…According to the literature, cutting needle biopsy is an efficient, rapid, and safe approach that offers sufficient biological tissue for the histopathological diagnosis and is used in the field of medicine which has to be further implemented in dentistry too. [ 17 18 19 20 21 ] A rabbit model study by Akan et al suggested that 14-, 16-, and 18- gauge cutting needles did not show any significant results whereas 18- and 20-gauge needles showed good results on hematoma by Yu et al [ 20 22 ]…”

Myoepithelioma of the Soft Palate: a Case Report Giving Special Attention to the Differential Diagnosis

“…However, in dentistry it is necessary to develop more studies to evaluate the effectiveness of this technique [9]. Additionally, Akan et al [26] compared cutting needles of 14-, 16- and 18-gauge in rabbit's experimental studies, to verify the possible intraoperative complications caused by those needles; however, they did not find relevant results. In contrast, Yu et al [24] found that hematoma occurred in patients who were submitted to cutting biopsy with needle with 18- and 20-gauge.…”

Image-guided Biopsy of Mesenteric, Omental, and Peritoneal Disease

“…The stomach is generally considered very low risk due to its thick wall and near sterility, with studies suggesting that needles as large as 18-gauge may be introduced without fear of peritonitis or bleeding. 57,58 The small bowel too is low risk, although smaller-gauge needles (20-to 22-gauge) are preferred. 28 By contrast, all attempts should be made to avoid the colon due to its high bacterial content, risk of peritonitis should spillage occur, and potential for contamination of the biopsy specimen.…”