Guided versus blind liver biopsy for chronic hepatitis C: clinical benefits and costs - PubMed
Comparative Study
Guided versus blind liver biopsy for chronic hepatitis C: clinical benefits and costs
R J Farrell et al. J Hepatol. 1999 Apr.
Abstract
Background/aims: Our objectives were: (1) to assess the clinical benefits and costs of performing ultrasound-guided liver biopsy with an automated needle compared to blind biopsy with a conventional Trucut needle in patients with chronic hepatitis C; (2) to compare the histological yield of automated needles with Trucut needles.
Methods: We prospectively studied 166 patients with hepatitis C virus who underwent either ultrasound-guided biopsy using automated ASAP needles or blind biopsy using conventional Trucut needles. Both groups were matched for age, sex, cirrhosis, needle gauge and operator experience. Patient tolerance, complications and histological adequacy were assessed. In a separate in vitro study, we assessed the histological adequacy of liver biopsy specimens obtained using automated and Trucut needles from 10 fresh autopsy cases.
Results: Ultrasound-guided biopsy caused significantly less biopsy pain (36.4% vs. 47.3%; p < 0.0001) and significantly less pain-related morbidity (1.8% vs. 7.7%, p < 0.05). Although, there was no significant difference in diagnostic yield between guided and blind biopsy (98% vs. 94%, p = 0.15), 3 blind biopsies (3.3%), including 2 which yielded extra-hepatic tissue, had to be repeated. The additional expense of performing guided liver biopsy with automated needles was 42 Irish Pounds per patient. In vitro, automated ASAP 15G needles provided liver specimens comparable to Trucut 15G needles and had the highest histopathologic score among the automated needles assessed.
Conclusions: Even in the absence of major complications, ultrasound-guided liver biopsy with an automated needle in HCV patients is safer, more comfortable and only marginally more expensive than blind Trucut biopsy.
Similar articles
-
The role of ultrasonography and automatic-needle biopsy in outpatient percutaneous liver biopsy.
Lindor KD, Bru C, Jorgensen RA, Rakela J, Bordas JM, Gross JB, Rodes J, McGill DB, Reading CC, James EM, Charboneau JW, Ludwig J, Batts KP, Zinsmeister AR. Lindor KD, et al. Hepatology. 1996 May;23(5):1079-83. doi: 10.1002/hep.510230522. Hepatology. 1996. PMID: 8621137 Clinical Trial.
-
Maciel AC, Marchiori E, de Barros SG, Cerski CT, Tarasconi DP, Ilha Dde O. Maciel AC, et al. Arq Gastroenterol. 2003 Apr-Jun;40(2):80-4. doi: 10.1590/s0004-28032003000200004. Epub 2004 Jan 16. Arq Gastroenterol. 2003. PMID: 14762476
-
[Transjugular liver biopsy: trucut or aspiration biopsy with modified Ross needles?].
Krupski G, Buggisch P, Koops A, Adam G. Krupski G, et al. Rofo. 2003 Feb;175(2):258-61. doi: 10.1055/s-2003-37241. Rofo. 2003. PMID: 12584628 German.
-
Why, who and how should perform liver biopsy in chronic liver diseases.
Sporea I, Popescu A, Sirli R. Sporea I, et al. World J Gastroenterol. 2008 Jun 7;14(21):3396-402. doi: 10.3748/wjg.14.3396. World J Gastroenterol. 2008. PMID: 18528937 Free PMC article. Review.
-
Ultrasound-guided percutaneous liver biopsy: indications, risks, and technique.
Copel L, Sosna J, Kruskal JB, Kane RA. Copel L, et al. Surg Technol Int. 2003;11:154-60. Surg Technol Int. 2003. PMID: 12931297 Review.
Cited by
-
Liver biopsy: when, how, by whom, and where?
McGill DB. McGill DB. Curr Gastroenterol Rep. 2001 Feb;3(1):19-23. doi: 10.1007/s11894-001-0036-1. Curr Gastroenterol Rep. 2001. PMID: 11177690 Review.
-
Liver biopsy for histological assessment: The case in favor.
Alswat KA, Mumtaz K, Jafri W. Alswat KA, et al. Saudi J Gastroenterol. 2010 Apr-Jun;16(2):133-9. doi: 10.4103/1319-3767.61245. Saudi J Gastroenterol. 2010. PMID: 20339188 Free PMC article.
-
Safety and effectiveness of blind percutaneous liver biopsy: analysis of 1412 procedures.
Szymczak A, Simon K, Inglot M, Gladysz A. Szymczak A, et al. Hepat Mon. 2012 Jan;12(1):32-7. doi: 10.5812/kowsar.1735143x.4388. Epub 2012 Jan 20. Hepat Mon. 2012. PMID: 22451841 Free PMC article.
-
Percutaneous liver biopsy: what is the current approach? Results of a questionnaire survey.
Mayoral W, Lewis JH. Mayoral W, et al. Dig Dis Sci. 2001 Jan;46(1):118-27. doi: 10.1023/a:1005665910159. Dig Dis Sci. 2001. PMID: 11270775
-
Who should be performing liver biopsies?
Ghent CN. Ghent CN. Can J Gastroenterol. 2009 Jun;23(6):437-8. doi: 10.1155/2009/756584. Can J Gastroenterol. 2009. PMID: 19543575 Free PMC article. No abstract available.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources