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Complications of percutaneous liver biopsy with Klatskin needles: a 36-year single-centre experience.

ABSTRACT: BACKGROUND:Liver biopsy is the gold standard in evaluating liver diseases but is susceptible to complications. Safety data on aspiration needle biopsies remain limited. AIM:To evaluate the safety of percutaneous liver biopsy performed with Klatskin needle. METHODS:Clinical and biochemical data were retrospectively retrieved from sequential subjects who underwent liver biopsy with Klatskin needle from 1978 to 2015. Subjects with complications underwent thorough chart reviews for hospital course. RESULTS:Of 3357 biopsies performed, complications occurred in 135 (4%) biopsies with 33 (1%) resulting in major complications. Severe pain occurred in 78 (2.3%) subjects and bleeding occurred in 21 (0.6%) subjects. Biliary injury occurred in 8 (0.2%) biopsies. Three subjects died as a result of massive intraperitoneal bleeding. Compared to viral hepatitis, biopsies performed with certain diagnosis had significantly higher odds of major complications: NRH (OR: 17), DILI (OR: 20), GVHD (OR: 32) and HCC (OR: 34). Subjects with major complications had higher pre-biopsy median AP (153 vs. 78 U/L, P < 0.001), ALT (105 vs. 64 U/L, P < 0.05), AST (62 vs. 47 U/L, P < 0.02), along with marginally lower total bilirubin (1.0 vs. 0.7 mg/dL, P < 0.01) and albumin (3.7 vs. 4.0 g/dL, P < 0.001). By multivariate backward logistic regression, platelets ?100 K/?L and aPTT >35 were independent risk factors of post-biopsy bleeding. CONCLUSION:Klatskin needle liver biopsies are safe with rare procedural morbidity. Our data suggests certain acutely ill subjects and those with systemic illnesses may be at higher risk of major complications. Clinicians should weigh the risks and benefits of liver biopsy in these patients with other alternative approaches.

SUBMITTER: Takyar V

PROVIDER: S-EPMC5290209 | biostudies-literature | 2017 Mar

REPOSITORIES: biostudies-literature

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Complications of percutaneous liver biopsy with Klatskin needles: a 36-year single-centre experience.

Takyar V V Etzion O O Heller T T Kleiner D E DE Rotman Y Y Ghany M G MG Fryzek N N Williams V H VH Rivera E E Auh S S Liang T J TJ Hoofnagle J H JH Koh C C

Alimentary pharmacology & therapeutics 20170110 5

<h4>Background</h4>Liver biopsy is the gold standard in evaluating liver diseases but is susceptible to complications. Safety data on aspiration needle biopsies remain limited.<h4>Aim</h4>To evaluate the safety of percutaneous liver biopsy performed with Klatskin needle.<h4>Methods</h4>Clinical and biochemical data were retrospectively retrieved from sequential subjects who underwent liver biopsy with Klatskin needle from 1978 to 2015. Subjects with complications underwent thorough chart reviews ...[more]

PMID: 28074540

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Project description:BackgroundEndovascular aortic repair (EVAR) is obviously less invasive than open aortic repair (OAR) for the treatment of infra-renal abdominal aortic aneurysm (AAA). However, it is not free of complications which can potentially result in severe morbidity or even mortality. The purpose of this study was to share our single-center experience with stent-graft related and systemic complications associated with EVAR.MethodsPatients with infra-renal AAA treated by elective and emergency EVAR between March 2014 and November 2020 were retrospectively identified. Demographic data, risk factors, American Society of Anesthesiologists (ASA) score, systemic complications, stent-graft related complications, surgical site complications, 30-day mortality, late EVAR related mortality, estimated blood loss, intensive care unit (ICU) length of stay (LOS), hospital LOS and follow-up durations were collected and analyzed.ResultsA total of 43 patients underwent EVAR during the period of study. There were 42 males (97.7%) and 1 female (2.3%). The mean age was 68.8 ± 6.2 years. Elective EVAR was performed in 36 (83.7%) and emergency EVAR in 7 (16.3%). Technical success was achieved in 42 patients (100%) with no conversion to OAR. Stent-graft related complications were (21.0%) endoleaks, (2.3%) graft limb occlusion, (0%) graft infection, and (2.3%) rupture-EVAR. Systemic complications were (2.3%) myocardial infarction (MI), (2.3%) stroke, (2.3%) spinal cord injury (SCI), (2.3%) respiratory failure, (19.0%) wound complications, and (2.3%) acute lower limb ischemia (ALI). The 30-day mortality was (2.3%) due to perioperative MI and the late graft related mortality was (2.3%) due to rupture-EVAR.ConclusionEVAR showed a high technical success rate with no conversion to OAR. The most common complications were type II and type I endoleaks followed by graft limb occlusion. The 30-day mortality was 2.3% due to perioperative MI. Only one late stent-graft related mortality was registered due to rupture-EVAR.

Dataset Information

Complications of percutaneous liver biopsy with Klatskin needles: a 36-year single-centre experience.

Publications

Complications of percutaneous liver biopsy with Klatskin needles: a 36-year single-centre experience.

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