Reduced Mortality Rates Following Elective Percutaneous Liver Biopsies
ABSTRACT Estimates of complication rates following elective percutaneous liver biopsy vary and might not accurately reflect current practice. We studied mortality and complication rates, by indication, in patients after they underwent liver biopsies.
We performed a study using hospital episode statistics collected by the National Health Service in England from 1998 to 2005 of elective percutaneous liver biopsies; data were linked with those from the Office for National Statistics to determine mortality rates. Using data from 61,187 people who underwent liver biopsies, all-cause mortality at 7 and 30 days after biopsy, 7-day mortality directly related to liver biopsy, and episodes of bleeding up to 7 days after biopsy were determined.
Overall all-cause mortality by 7 days after biopsy was 2 per 1000 biopsies (95% confidence interval, 1.8-2.5); this rate varied markedly by indication for biopsy, with rates as high as 12 per 1000 for patients investigated for cancer. Death within 7 days directly related to liver biopsy occurred, at most, every 1 in 10,000 biopsies in patients investigated for liver disease or abnormal liver function test results. Overall, 6 episodes of major bleeding occurred per 1000 biopsies.
All-cause mortality risk following elective percutaneous liver biopsy is approximately 0.2%, with a higher risk of major bleeding. Deaths directly related to liver biopsy occur approximately 1 in every 10,000 biopsies. This risk is substantially lower than that of previous reports, indicating that the safety of this procedure has improved.
- SourceAvailable from: Ali Nawaz Khan
Chapter: Complications of Liver BiopsyLiver Biopsy, 09/2011; , ISBN: 978-953-307-644-7
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ABSTRACT: To assess the feasibility of texture analysis for classifying fibrosis stage and necroinflammatory activity grade in patients with chronic hepatitis C on T2-weighted (T2W), T1-weighted (T1W) and Gd-EOB-DTPA-enhanced hepatocyte-phase (EOB-HP) imaging. From April 2008 to June 2012, MR images from 123 patients with pathologically proven chronic hepatitis C were retrospectively analyzed. Texture parameters derived from histogram, gradient, run-length matrix, co-occurrence matrix, autoregressive model and wavelet transform methods were estimated with imaging software. Fisher, probability of classification error and average correlation, and mutual information coefficients were used to extract subsets of optimized texture features. Linear discriminant analysis in combination with 1-nearest neighbor classifier (LDA/1-NN) was used for lesion classification. In compliance with the software requirement, classification was performed based on datasets from all patients, the patient group with necroinflammatory activity grade 1, and that with fibrosis stage 4, respectively. Based on all patient dataset, LDA/1-NN produced misclassification rates of 28.46%, 35.77% and 20.33% for fibrosis staging and 34.15%, 25.20% and 28.46% for necroinflammatory activity grading in T2W, T1W and EOB-HP images. In the patient group with necroinflammatory activity grade 1, LDA/1-NN yielded misclassification rates of 5.00%, 0% and 12.50% for fibrosis staging in T2W, T1W and EOB-HP images respectively. In the patient group with fibrosis stage 4, LDA/1-NN yielded misclassification rates of 5.88%, 12.94% and 11.76% for necroinflammatory activity grading in T2W, T1W and EOB-HP images respectively. Texture quantitative parameters of MR images facilitate classification of the fibrosis stage as well as necroinflammatory activity grade in chronic hepatitis C, especially after categorizing the input dataset according to the activity or fibrosis degree in order to remove the interference between the fibrosis stage and necroinflammatory activity grade on texture features.PLoS ONE 03/2015; 10(3):e0118297. DOI:10.1371/journal.pone.0118297 · 3.53 Impact Factor
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ABSTRACT: Background/Aim: Ultrasound marking by radiologists prior to percutaneous liver biopsy (PLB) results in biopsy site adjustment, decreased pain related complications and improved tissue yield. Minimal data exists on the impact of ultrasound marking by gastroenterologists on these parameters. The study aim was to evaluate whether ultrasound marking by gastroenterologists results in improved PLB tissue yield, fewer needle passes and decreased biopsy failure rates compared to blind biopsy, eliminating the need for a separate radiological evaluation. Methodology: All PLB performed by gastroenterologists from June 1999 to February 2003 at the University of Florida College of Medicine, Jacksonville, were reviewed retrospectively. Data collected included ultrasound marked or blind PLB, demographics, indication, number of passes performed, and specimen length, if obtained. Results: Four hundred and eighty PLB were included: 328 performed with ultrasound marking and 152 blind. Ultrasound marking by gastroenterologists prior to PLB resulted in fewer passes and longer specimens as well as a decreased failure rate in ultrasound marked compared to blind PLB. Conclusions: Ultrasound marking by gastroenterologists prior to PLB provided significantly larger tissue samples, fewer needle passes and a decreased biopsy failure rate compared to blind PLB. This removes the need for a separate radiological evaluation on the procedure day.Hepato-gastroenterology 01/2013; 60(126). DOI:10.5754/hge121106 · 0.91 Impact Factor