Needle Biopsy of the Liver

ASPIRATION BIOPSY OF THE LIVER with Special Reference to the Method of Iversen‐Roholm.

“…By means of the examinations with biopsy it became possible to follow step by step the progressive as well as the regressive changes, and thus to arrive at a far more correct and vivid understanding of the relation of the acute hepatitis to the subchronic and chronic forms and the transition to cirrhosis ; further, it was demonstrated how relatively soon even fairly severe cirrhotic changes might develop. (18,25,27). The previous view that the content of glycogen of the liver cells was greatly reduced in hepatitis was proved to be wrong by means of histological examinations.…”

“…A total of 736 biopsies had been communicated, with 7 deaths in all, i. e. a mortality af about I per cent. In the more rccent iiterature on biopsy of the liver the question of the risk has, of course, been discussed repeatedly (4, 13,15,17,18,35,50). With a view to the risk of hmiorrhage the technique has been modified many times (IS, 17, 18, 35, 50, 54).…”

Risks of Needle Biopsy of the Liver

“…(1950) Needle biopsy of the liver has now been adopted in many institutions throughout the world, but it is still regarded with misgiving by those who recall the frequent complications encountered by the pioneers of this procedure. Their doubts are not allayed by the high mortality figures mentioned in the literature, such as 1.0% by Snapper (1951), 0.93% by Kumpe (1949), 0.89% by Hoffbauer (1947), 0.60% by Webb and Werthammer (1949), 0.5% by Lichtman (1949), 0.3% by Sherlock (1949. The situation was in fact rather better than these figures suggested, for nearly three years ago there were records of 3,650 biopsies with seven deaths, a mortality rate of 0.19% (Terry, 1949b).…”

“…However, neither Sherlock (1945) nor Weisbrod et al (1950) mentioned this complication, though each had performed 157 biopsies on patients with jaundice. (Hoffbauer, 1947;Reynolds, 1950). The discovery of intestinal, pancreatic, or renal tissue in the histological preparation was usually the only evidence of this happening, though death followed one instance of puncture of the colon.…”

Just A Second

“…25,26 The cutting method using the split-pronged Vim-Silverman needle and canula 27 (requiring equally slow and intricate maneuvers) was the choice in the United States. [28][29][30] In both cases, the procedure required operator nerve, verve, and dexterity and patient fortitude, tenacity, and complaisance. As the intrahepatic dwell time in each case was unacceptably long, a fortiori, there had to be a better way.…”