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Clinical application of ultrasonography-guided percutaneous liver biopsy and its safety over 18 years

Clinical and Molecular Hepatology 2020년 26권 3호 p.318 ~ 327
장영, 김준일, 이보라, 김상균, 정민정, 김영석, 정승원, 장재영, 유정주,
소속 상세정보
장영 ( Chang Young ) - Soonchunhyang University College of Medicine Department of Internal Medicine
김준일 ( Kim Jun-Il ) - Soonchunhyang University College of Medicine Department of Internal Medicine
이보라 ( Lee Bo-Ra ) - Chung-Ang University Graduate School Department of Biostatistics
김상균 ( Kim Sang-Gyune ) - Soonchunhyang University College of Medicine Department of Internal Medicine
정민정 ( Jung Min-Jung ) - Soonchunhyang University College of Medicine Department of Pathology
김영석 ( Kim Young-Seok ) - Soonchunhyang University College of Medicine Department of Internal Medicine
정승원 ( Jeong Soung-Won ) - Soonchunhyang University College of Medicine Department of Internal Medicine
장재영 ( Jang Jae-Young ) - Soonchunhyang University College of Medicine Department of Internal Medicine
유정주 ( Yoo Jeong-Ju ) - Soonchunhyang University College of Medicine Department of Internal Medicine

Abstract


Background/Aims: Liver biopsy (LB) remains the gold standard for the evaluation of liver disease. However, over the past two decades, many noninvasive tests have been developed and utilized in clinical practice as alternatives to LB. The aim of this study was to evaluate the clinical use and safety of LB in the era of noninvasive assessment of liver fibrosis.

Methods: This retrospective study included 1,944 consecutive cases of LB performed between 2001 and 2018 in a tertiary hospital. All of the LBs were conducted under ultrasonography guidance with 18-gauge cutting needles.

Results: LBs were performed an average of approximately 108 times per year during the study period. Chronic hepatitis B (25.3%) and suspected malignancy (20.5%) were the two most common indications for LB. The use of LB for nonalcoholic fatty liver disease increased from 8.1% to 17.2% in the past 5 years compared to the last 10 years, while that for viral hepatitis decreased from 40.3% to 18.9%. Discordance rate between the suspected diagnosis and the final diagnosis was 2.6% (51 cases). The overall rate of major adverse events was 0.05% (one case), which involved delayed bleeding at the biopsy site. Liver cirrhosis was observed in 563 cases (28.9%), and the presence of cirrhosis did not affect the frequency of complications (P=0.289).

Conclusions: LB is widely used in clinical practice as an irreplaceable diagnostic tool, even in the era of noninvasiveness. Ultrasonography-guided LB can be performed safely in patients with liver cirrhosis.

키워드

Liver biopsy; Indication; Complication

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