Prospective audit of liver biopsy practice: Is bigger better?

Abstract

Background: Percutaneous liver biopsy remains an important toolin the diagnosis and staging of chronic liver disease. For reliableand reproducible interpretation, a specimen containing a minimum of six portal tracts and ideally more than ten is required.There is often reluctance to use wider bore needles because ofpotentially higher complication rates. Aims: To compare the ad-equacy of samples obtained using two different biopsy needles.Patients and Methods: Data was collected prospectively for 128ultrasound-sited percutaneous biopsies for chronic liver diseaseover a 10 month period using a proforma. Results: Indications forbiopsy were alcoholic liver disease (21%), NAFLD (21%), HCV(14%), HBV (8%), haemachromatosis (10%), autoimmune hepatitis(8%), other (22%). There were no serious adverse events in eithergroup. Biopsy characteristics are compared in Table 1. Data areexpressed as mean (CI) or median (range) and compared using ttest, Mann-Whitney U test or Chi-squared. Conclusions: Liverbiopsy samples obtained with a 15G Menghini needle are superiorto those obtained using an 18G Trucut needle. The latter are ofteninadequate for assessment using accepted criteria.