Incidence of Bleeding in 8172 Percutaneous Ultrasound-Guided Intraabdominal Diagnostic and Therapeutic Interventions – Results of the Prospective Multicenter DEGUM Interventional Ultrasound Study (PIUS Study)

Abstract

This prospective multicentre study confirms the broad spectrum of percutaneous US-guided intraabdominal interventions. However diagnostic liver biopsies dominate with the use of core needle biopsies (18 G). Percutaneous US-guided interventions performed by experienced sonographers are associated with a low bleeding risk. Major bleeding complications are very rare. A pre-interventional INR < 1.5 and individual medication risk assessment are recommended.

Liver Stiffness Measured by 2‐Dimensional Shear Wave Elastography: Prospective Evaluation of Healthy Volunteers and Patients With Liver Cirrhosis

“…The reference standard for the diagnosis of liver fibrosis (staging) and cirrhosis is liver biopsy . This procedure is invasive, is sometimes painful, and has rare but potentially serious complications . Furthermore, a biopsy cylinder represents only 1 per 50,000 of the entire liver tissue, which is associated with the risk of a “sampling error.” In addition, high interobserver and intraobserver variability has been reported …”

Aktualisierte S2k-Leitlinie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) „Komplikationen der Leberzirrhose“

“…Hier zeigte sich eine insgesamt niedrige Blutungskomplikationsrate: in 0,4 % bedurfte es einer Transfusion, in 0,1 % eines operativen Eingriffs und in 0,05 % eines radiologischen Coilings. Trotz der insgesamt niedrigen Blutungskomplikationsrate zeigte die Studie jedoch eine signifikant höhere Blutungsrate bei einem INR-Wert > 1,5 [27].…”

Reduced complication rates of percutaneous transhepatic biliary drainage with ultrasound guidance

“…In contrast, in a recent prospective multicenter study that analyzed complications in 5,903 US‐guided diagnostic and therapeutic punctures of the liver among other organs, severe bleeding could be documented in 0.22% and procedure‐related deaths in only 0.05%. In the subgroup of 723 therapeutic US‐guided liver interventions, severe bleeding did not occur at all . These differences can be explained by the visualization of arterial and portal venous supply in real time using Doppler‐assisted puncture technique.…”

“…In the subgroup of 723 therapeutic US-guided liver interventions, severe bleeding did not occur at all. 23 These differences can be explained by the visualization of arterial and portal venous supply in real time using Doppler-assisted puncture technique.…”