Percutaneous Liver Biopsy With Plugging of Needle Track: A Safe Method for Use in Patients With Impaired Coagulation

Riley, S.A.; Irving, Henry; Axon, A. T. R.; Ellis, W R; Lintott, D. J.; Losowsky, M. S.

doi:10.1016/s0140-6736(84)92910-6

Cited by 52 publications

(24 citation statements)

References 7 publications

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“…For other approaches, Riley and colleagues7 reported one case of a fatal haemorrhage after a plugged liver biopsy in a series of 20 patients. Lebrec and colleagues,15 in an analysis of 1000 transvenous liver biopsies, reported one death resulting from perforation of the liver capsule, and perforation of the liver capsule in five, haematoma at the site of cannulation in 10, pneumothorax in two, transient supraventricular tachycardia in six, and abdominal pain in 74 patients.…”

Section: 0 Backgroundmentioning

confidence: 99%

Guidelines on the use of liver biopsy in clinical practice

Grant

Neuberger

1999

Gut

342

306

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Section: 0 Backgroundmentioning

confidence: 99%

Guidelines on the use of liver biopsy in clinical practice

Grant

Neuberger

1999

Gut

342

306

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“…prothrombin time prolongation !6 s or platelet count 20-80 ! 10 9 /l [5][6][7]. To our experience, this method also seems safe in ascites, and even in patients with the combination of coagulopathy and ascites.…”

Section: Discussionmentioning

confidence: 69%

“…Since the paper by Riley et al [6] in 1984, percutaneous liver biopsy with plugging of the needle track can be considered as an alternative method for obtaining liver tissue in patients with clotting disorders. It is easier to perform and much quicker than transjugular liver biopsy, which also seems to be safe, but is more time-consuming and more difficult to perform.…”

Section: Discussionmentioning

confidence: 99%

“…This technique, however, is invasive since the internal jugular vein has to be cannulated, is time-consuming, and the diagnostic yield is often disappointing due to small biopsies. Percutaneous liver biopsy in which the needle is plugged with absorbable foam is a wellknown procedure in coagulation disorders [6]. It is easy to perform, requires no intravenous cannulation, and is less time-consuming than transjugular biopsy.…”

Section: Introductionmentioning

confidence: 99%

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Plugged-Percutaneous Liver Biopsy in Patients with Impaired Coagulation and Ascites

Kamphuisen¹,

Wiersma²,

Mulder³

et al. 2002

Pathophysiol Haemos Thromb

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In liver cirrhosis coagulation is impaired due to decreased synthesis of vitamin K-dependent and vitamin K-independent coagulation factors. In such patients routine liver biopsy is contraindicated due to the increased risk of bleeding. Treatment with recombinant factor VIIa or fresh frozen plasma reduces the complication rate of liver biopsy, but both have disadvantages. In this observational study, we evaluated the safety and efficacy of plugged-percutaneous liver biopsy in 36 patients with ascites (n = 9), impaired coagulation (n = 22), or both (n = 5) due to severe chronic liver disease. Among patients with clotting disorders, mean prothrombin time was 16.3 s (range 11.4–20.3) and the mean platelet count was 53 × 10⁹/l (range 19–153). Plugged-percutaneous liver biopsy was in none of the cases associated with bleeding complications (95% confidence interval 0–0.097). All biopsies were adequate for histological interpretation and therefore diagnostically successful. In our experience, plugged-percutaneous liver biopsy seems a safe and reliable method in patients with chronic liver disease associated with impaired coagulation and/or ascites needing histological evaluation.

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“…Therefore the risk of hemorrhage after liver biopsy in this group of patients is high, as expected. In our opinion, if liver biopsy should be done in CRF patients, transjugular liver biopsy can be performed, as proven safe and efficient [7], or plugging of needle track with absorb able gelatin sponge may be chosen as was successfully done in patients with impaired blood coagulation [8,9].…”

Section: Percutaneous Liver Biopsy Complications In Patients With Chrmentioning

confidence: 99%