Diagnostic CT - guided hepatic biopsy in the presence of ascites : complication rates

Congress:

ECR 2019

Poster Number:

C-1899

Type:

Scientific Exhibit

Keywords:

Cancer, Complications, Biopsy, CT, Liver, Interventional non-vascular, Abdomen

Authors:

D. Stefanou¹, A. Hopkins¹, C. Cambakis¹, E. Lazaridou², D. Exarhos¹; ¹ATHENS/GR, ²Holargos-Attiki/GR

DOI:

10.26044/ecr2019/C-1899

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-1899

Fig. 1: Hepatomegaly, slight ascites and focal lesion. A 18/9 G needle was used and the...

Fig. 2: Focal liver biopsy with prior to biopsy moderate ascites which was aspirated...

Fig. 3: Multiple lesions in the liver parenchyma and presence of slight ascitic fluid...

Aims and objectives

To evaluate the safety of performing CT-guided percutaneous liver biopsy in the presence of ascites and whether the presence of ascites is a contraindication of performing one.

Methods and materials

This is a single centered retrospective study in a cohort of 16 patients, 9 males and 7 females, during the last 12 months, between 54-82 years old with ascites who underwent image – guided hepatic biopsy in order to be determined the cause oh hepatic failure and to diagnosed a focal hepatic lesion or diffuse impairment of the hepatic parenchyma. Each patient was fully informed over the necessity of the biopsy, the procedure and the possible complications. A written consent from each patient was signed....

Results

Out of 16 patients, 3 patients had sever ascites, 1 had hemorrhagic sever ascites ,4 had moderate and 8 had slight (6 free/ 2 encapsulated). The patients with severe ascites had evacuation of the ascitic fluid by an interventional radiologist placing an arrow catheter under ultrasound guidance and the patients with moderate ascites had aspiration of the ascitic fluid without placing any catheter by a 4mm needle. 8 patients with slight ascites did not undergo a pre biopsy evacuation. All our patients tolerated the biopsy...

Conclusion

In summary, despite the small amount of our patients (16), in this retrospective analysis there were no major complications reported. CT-guided percutaneous liver biopsy in the presence of ascitic fluid, despite the type or amount of it, is not a contraindication for liver biopsy.

Personal information

Danai Stefanou, MD, Radiology Resident [email protected] Demetrios Exarhos,MD, PhD, Interventional Radiologist [email protected] Evangelismos Hospital, Department of CT-MRI, Athens, GR

References

1.Little, Andrew F., et al. "Image-guided percutaneous hepatic biopsy: effect of ascites on the complication rate."Radiology199.1 (1996): 79-83. 2.Rockey, Don C., et al. "Liver biopsy."Hepatology49.3 (2009): 1017-1044. 3.Murphy, F. B., et al. "CT-or sonography-guided biopsy of the liver in the presence of ascites: frequency of complications."American Journal of Roentgenology151.3 (1988): 485-486. 4.Kamphuisen, Pieter W., et al. "Plugged-percutaneous liver biopsy in patients with impaired coagulation and ascites."Pathophysiology of haemostasis and thrombosis32.4 (2002): 190-193.