背景:多种肝脏疾病与特征性组织病理学发现相关,有助于其诊断和治疗。然而,经皮肝穿刺活检(PLB)容易出现局限性和并发症。我们评估了13年来在我们医院做的所有PLB,旨在评估PLB的效用和并发症。
方法:所有PLB都在雅典一所三级大学医院的内科部门进行,希腊,在13年期间进行了审查。记录的数据包括人口统计特征,活检当天获得的实验室结果,肝活检指征,以及副作用的发生。所有患者均在出院后随访1个月,以了解可能的PLB相关并发症。
结果:研究期间共有261名患者接受了PLB。PLB最常见的适应症是肝脏肿块调查,其次是转氨酶血症。PLB协助218例患者进行了诊断,仅43例没有帮助,其中14例是由于活检标本不足或不适当。由PLB引起的并发症很少见,有10名患者表现出疼痛,在活检部位或右肩,和3例出血发作;没有死亡记录。
结论:我们的研究表明,在日常实践中,PLB仍然是一种强大的诊断工具,前提是在指示时使用。
BACKGROUND: A variety of liver disorders are associated with characteristic histopathological findings that help in their diagnosis and treatment. However, percutaneous liver biopsy (PLB) is prone to limitations and complications. We evaluated all PLBs done in our hospital in a 13-year period, aiming to assess PLB\'s utility and complications.
METHODS: All PLBs conducted in an internal medicine department of a tertiary university hospital in Athens, Greece, during a 13-year period were reviewed. Recorded data included demographic characteristics, laboratory results acquired on biopsy day, indication for liver biopsy, and occurrence of side effects. All patients were followed for 1 month post-hospital discharge for possible PLB-related complications.
RESULTS: A total of 261 patients underwent PLB during the
study period. The commonest indication of PLB was investigation of liver mass, followed by transaminasemia. PLB assisted in setting a diagnosis in 218 patients and was unhelpful in only 43, in 14 of them due to inadequate or inappropriate biopsy specimen. Complications attributable to PLB were rare, with 10 patients exhibiting pain, either at biopsy site or in the right shoulder, and 3 having bleeding episodes; no deaths were noted.
CONCLUSIONS: Our
study shows that PLB is still a powerful diagnostic tool in everyday practice, provided it is used when indicated.