Keywords:
Abdomen, Ultrasound, Biopsy, Liver
Authors:
D. Christodoulou, J. Bajwa, K. Drinkwater, D. Lawrence, S. Barter, A. Nicholson, D. Howlett; London/UK
DOI:
10.1594/ecr2012/C-1540
Conclusion
Advances in knowledge
- Data from this national study confirms the trend towards the use of image guidance,
or assistance,
in the performance of liver biopsies (Table 2).
- Most procedures are undertaken by radiologists using ultrasound as the imaging modality (Table 4).
- Focal lesions are more at risk of major complications post-biopsy (p = 0.0008).
- The overall mortality in the study was 0.11% with a diagnostic accuracy for focal lesions of 96.43%.
- We found no statistically significant link between INR/platelet counts and major bleeding complications.
Implications for patient care
- Although the majority of audit standards were met in practice,
this study highlights the need for careful procedural documentation,
in particular for a completed consent form and post-procedural instructions to be contained within the patient record (Table 6).
- In elective,
low risk cases,
INR/platelet counts should be checked in the week before the procedure and results documented.
- Access to transjugular liver biopsy and plugged biopsy for high risk patients is relatively restricted (Tables 2 and 4) and could adversely affect complication rates.
ACTION PLANNING AND RE-AUDITING
- To the best of our knowledge this series represents the largest of its kind in available current literature and the study gives an indication of current UK radiological practice.
- There is scope for departments to produce action plans and re-audit locally with particular regard to biopsy documentation and preparation.