Multiple biopsy passes improves the diagnostic yield of liver biopsies, but also increases the risk of complications, such as post procedural pain and bleeding [1]. An adequate non-targeted liver biopsy sample should contain at least 11 portal tracts [2]. To obtain sufficient tissue, the recommended needle size for liver biopsies is 16 gauge, with a minimum sample length of 20mm [2-4]. However, the correlation between the length of tissue sample and the number of portal tracts obtained with an 18 gauge BioPince needle is uncertain....

A retrospective study of 19 patients who underwent percutaneous non-targeted liver biopsy with the 18 gauge BioPince needle from August 2021 to January 2023 at a single institution was performed. Targeted biopsies of specific liver lesions and those without records of the number of portal tracts obtained were excluded. The biopsy sample length and the number of portal tracts for each biopsy was recorded, with information obtained from cytological and histopathological reports. The mean and standard deviation of the biopsy length required for 11 portal...

Liver biopsies were diagnostic in 89% of cases, with the number of portal tracts ranging from 10 to 57 (with an average of 25). Non diagnostic cases (2/19) were querying primary sclerosing cholangitis, which due to its patchy nature, is difficult to diagnose on liver biopsy [5]. The total biopsy length for each sample ranged from 15 to 111mm, with an average of 59mm. The mean biopsy length required to obtain 11 portal tracts +/- the standard deviation was 26.4mm +/- 9.6mm. Plotting a linear...

Liver biopsies using an 18 gauge BioPince needle theoretically require 56mm of tissue to achieve an adequate sample in 99.85% of cases. Therefore 2 passes of 30cm throws or 3 passes of 20cm throws should be used routinely for non-targeted liver biopsies with the 18 gauge BioPince needle to achieve an adequate sample while minimizing risk of complications. The length of biopsy sample required, in this study, exceeds that of previous reports [2]. One explanation is the difference in needle size (comparing the 18 gauge...

Chi H, Hansen BE, Tang WY, Schouten JN, Sprengers D, Taimr P, et al. Multiple biopsy passes and the risk of complications of percutaneous liver biopsy. Eur J Gastroenterol Hepatol. 2017;29(1):36-41. Rockey DC, Caldwell SH, Goodman ZD, Nelson RC, Smith AD. Liver biopsy. Hepatology. 2009;49(3):1017-44. Kumar M, Andi A, Lucas S, Wilkinson M, Ahmad I, Sabharwal T, et al. PWE-120 Liver Biopsy Using 16 G Needle: A Comparative Study. Gut. 2013;62(Suppl 1):A179-A80. Neuberger J, Patel J, Caldwell H, Davies S, Hebditch V, Hollywood C, et...