VIDEO ASSISTED HEPATIC BIOPSY TECHNIQUE BY MINIMUM INVASIVE DEVICE
Abstract
Percutaneous liver biopsy is the gold standard for obtaining a sample of liver tissue, however some patients have contraindications to this method. In these situations, a sample of liver tissue must be obtained by another approach, opting for laparoscopic or video-assisted liver biopsy. This technique allows an accurate inventory of the cavity, leading to a good assessment of the liver parenchyma without increasing the risk of bleeding. The aim of this study is to systematize a video-assisted surgical technique capable of obtaining a sufficient sample of liver tissue by means of a biopsy performed with a Trucut needle. The needle will be introduced by an adapted device that will allow the sample to be obtained by minilaparoscopy followed by hemostasis of the parenchyma without using additional trocars. This study is of diagnostic accuracy and patients were recruited who underwent abdominal video surgery and who presented moderate to severe steatosis. Patients are randomized into two groups: laparoscopic liver biopsy technique (n = 10, control group) and minilaparoscopic liver biopsy technique (n = 08, experimental group), with no statistical difference regarding gender and type of surgery. The experimental group had a significantly shorter time compared to the average procedure time (p = 0.003), biopsy time (p = 0.002) and hemostasis time (p = 0.003). The mini-laparoscopic biopsy technique using an adapted device proved to be capable of obtaining sufficient tissue sample, in a minimally invasive manner and in less time.
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References
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26. DECHÊNE, A. SOWA, JP. SCHLATTJAN, M. WREE, A. BLOMEYER, S. BEST, J. MALDONADO, EJ. BECHMANN, LP. GERKEN, G. BABA, HA. SYN, WK. CANBAY, A. Mini-laparoscoy guided liver biopsy increases diagnostic accuracy in acute liver failure. 2014, S. Karger AG, Basel. 240 – 247. DOI:10.1159/000366517
27. HUANG, JY. LU, Q. LIU, JB. Delayed hepatic rupture post ultrasound-guided percutaneous liver biopsy – a case report. Medicine 2018; 97: 1 – 4. DOI:10.1097/MD.0000000000009955
28. PICCININO, F. SAGNELLI, E. PASQUALE, G. GIUSTI, G. Complications following percutaneous liver biopsy. A multicentre retrospective study on 68.276 biopsies. J Hepatol 1986; 2: 165 – 173. DOI:10.1016/s0168-8278(86)80075-7
29. BOSCHUETZ, N. GRAY, M. BARI, K. Portal vein thrombosis after percutaneous liver biopsy. Clinical Gastroenterology and Hepatology 2018; 16: 5 – 6. DOI:10.1016/j.cgh.2017.07.027
30. PENA, LR. HORN, TL. CROSS, CB. Acute pancreatitis secondary to hemobilia after percutaneous liver biopsy. Therap Adv Gastroenterol 2009; 2: 165 – 168. DOI:10.1177/1756283X08103654
31. ZHU, JZ. ZHOU, QY. WANG, YM. DAI, YN. ZHU, J. YU, CH. LI, YM. Prevalence of fatty liver disease and the economy in China: A systematic review. World J Gastroenterol 2015; 21: 5695 – 5706. DOI:10.3748/wjg.v21.i18.5695
32. BRAVO, AA. SHETH, SG. CHOPRA, S. Liver biopsy. N Engl J Med 2001; 344: 495 – 500. DOI:10.1056/NEJM200102153440706
33. SCHEUER, PJ. Liver biopsy size matters in chronic hepatitis: bigger is better. Hepatology 2003; 38: 1356 – 1358. DOI:10.1016/j.hep.2003.10.010
2. CZAJA, AJ. CARPENTER, HA. Optimizing diagnosis from the medical liver biopsy. Clin Gastroenterol Hepatol 2007; 5; 898 – 907.
DOI:10.1016/j.cgh.2007.05.031
3. FILINGERI, V. FRANCIOSO, S. SFORZA, D. SANTOPAOLO, F. ODDI, FM. TISONE, G. A retrospective analysis of 1.011 percutaneous liver biopsies performed in patients with liver transplantation or liver disease: ultrasonography can reduce complications? European Review for Medical and Pharmacological Sciences, 2016; 20: 3609 – 3617. PMID: 27649662
4. OVCHINSKY, N. MOREIRA, RK. LEFKOWITCH, JH. et al. Liver biopsy in modern clinical practice: a pediatric point-of-view. Adv anat Pathol 2012; 19; 250 – 262. DOI:10.1097/PAP.0b013e31825c6a20
5. GHENT, Cameron N. Percutaneous liver biopsy: Reflections and refinements. Can J Gastroenterol. 2006 Feb; 20(2): 75 – 79. DOI: 10.1155/2006/452942
6. CADRANEL, JF. RUFAT, P. DEGOS, F. Practices of Liver Biopsy in France: Results of a Prospective Nationwid - Survey. Hepatology 32; 477 – 481; 2000. DOI:10.1053/jhep.2000.16602
7. BRAVO, AA. SHETH, SG. CHOPRA, S. Liver biopsy. N Engl J Med 2001; 344: 495 – 500. DOI:10.1056/NEJM200102153440706
8. SCHEUER, PJ. Liver biopsy size matters in chronic hepatitis: bigger is better. Hepatology 2003; 38: 1356 – 1358. DOI:10.1016/j.hep.2003.10.010
9. LIU, A. GALOOSIAN, A. KASWALA, D. LI, AA. GADIPARTHI, C. CHOLANKERIL, G. KIM, D. AHMED, A. Nonalcoholic fatty liver disease: epidemiology, liver transplantation trends and outcomes, and risk of recurrent disease in the graft. Journal of Clinical and Translational Hepatology 2018; 6: 420 – 424. DOI:10.14218/JCTH.2018.00010
10. SAKAMOTO, M. TSUJIKAWA, H. EFFENDI, K. OJIMA, H. HARADA, K. ZEN, Y. KONDO, F. NAKANO, M. KAGE, M. SUMIDA, Y. HASHIMOTO, E. YAMADA, G. OKANOUE, T. KOIKE, K. Pathological findings of nonalcoholic steatohepatitis and nonalcoholic fatty liver disease. Pathol Int 2017; 67: 1 – 7.
DOI:10.1111/pin.12485
11. BRUNT, EM. Nonalcoholic fatty liver disease and the on going role of liver biopsy evaluation. Hepatol Commun 2017; 1: 370 – 378. DOI:10.1002/hep4.1055
12. DENZER, U. HELMREICH-BECKER, I. GALLE, PR. LOHSE, AW. Liver assessment and biopsy in pacients with marked coagulopathy: value of mini-laparoscopy and control of bleeding. Am J Gastroenterol 2003; 98: 893 – 900. DOI:10.1111/j.1572-0241.2003.07342.x
13. WEICKERT, U. SIEGEL, E. SCHILLING, D. EICKHOFF, A. JAKOBS, R. BOHRER, MH. RIEMANN, JF. The diagnosis of liver cirrhosis: a comparative evaluation of standard laparoscopy, mini-laparoscopy and histology. Z Gastroenterol 2005; 43: 17 – 21. DOI:10.1055/s-2004-813874
14. HOFFMAN, A. RAHMAN, F. PRENGEL, S. SCHUCHMANN, M. GOTZ, M. MOEHLER, M. GALLE, PR. LI, Z. KALLOO, AN. KIESSLICH, R. Mini-laparoscopy in the endoscopy unit: safety and outcomes in over one thousand patients. World J Gastrointest Endosc 2011; 3: 6 – 10. DOI:10.4253/wjge.v3.i1.6
15. PONIACHIK, J. BERNSTEIN, DE. REDDY, KR. JEFFERS, LJ. COELHO-LITTLE, ME. CIVANTOS, F. SCHIFF, ER. The role of laparoscopy in the diagnosis of cirrhosis. Gastrointest Endosc 1996; 43: 568 – 571. DOI:10.1016/s0016-5107(96)70192-x
16. ROCKEY, DC. CALDWELL, SH. GOODMAN, ZD. NELSON, RC. SMITH, AD. American Association for the Study of Liver Diseases. Liver Biopsy. Hepatology 2009; 49: 1017 – 1044. DOI:10.1002/hep.22742
17. EISEMBERG, E. KONOPNIKI, M. VEITSMAN, E. KRAMSKAY, R. GAITINI, D. BARUCH, Y. Prevalence and characteristics of pain induced by percutaneous liver biopsy. Anesth Analog 2003; 96: 1392 – 1396.
DOI:10.1213/01.ane.0000060453.74744.17
18. NICOLAO, C. PACZKOSKI, RF. ELLENSOHN, L. A história da venopunção: a evolução dos cateteres agulhados periféricos ao longo dos tempos. Revista Conhecimento Online. Ano 05. Volume 01, 2013.
19. MACIEL, AC. SILVA DE BARROS, SG. TARASCONI, DP. SEVERO JUNIOR, LCV. CERSKI, TS. ILHA, DO. Experiência em pacientes com suspeita de hepatopatia crônica e contra-indicação para biópsia hepática percutânea utilizando a agulha de Ross modificada. Rev Ass Med Brasil, 2000; 46 (2): 134 – 142.
20. YOON, YI. KIM, KH. KANG, SH. KIM, WJ. SHIN, MH. LEE, SK. Pure laparoscopic versus open right hepatectomy for hepatocellular carcinoma in patients with cirrhosis: a propensity score matched analysis. Annals of Surgery. 2017; 265 (5): 856 – 863. DOI:10.1097/SLA.0000000000002072
21. LIPNIK, AJ. BROWN, DB. Image-guided percutaneous abdominal mass biopsy: technical and clinical considerations. Radiol Clin North Am 2015; 53: 1049 – 1059. DOI:10.1016/j.rcl.2015.05.007
22. OLSON, MC. ATWELL, TD. HARMSEN, WS. KONRAD, A. KING, RL. LIN, Y. et al. Safety and accuracy of percutaneous image-guided core biopsy of the spleen. AJR Am J Roentgenol 2016; 206: 655 – 659. DOI:10.2214/AJR.15.15125
23. PATEL, IJ. DAVIDSON, JC. NIKOLIC, B. et al. Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided interventions. J Vasc Interv Radiol 2012; 23 (6): 727 – 736. DOI:10.1016/j.jvir.2012.02.012
24. KITCHIN, DR. DEL RIO, AM. WOODS, M. LUDEMAN, L. HINSHAW, JL. Percutaneous liver biopsy and revised coagulation guidelines: a 9-year experience. Abdom Radiol 2018, 43 (6): 1494 – 1501. DOI:10.1007/s00261-017-1319-9
25. O’CONNOR, SD. TAYLOR, AJ. WILLIAMS, EC. WINTER, TC. Coagulation concepts update. AJR Am J Roentgenol 2009; 193 (6); 1656 – 1664. DOI:10.2214/AJR.08.2191
26. DECHÊNE, A. SOWA, JP. SCHLATTJAN, M. WREE, A. BLOMEYER, S. BEST, J. MALDONADO, EJ. BECHMANN, LP. GERKEN, G. BABA, HA. SYN, WK. CANBAY, A. Mini-laparoscoy guided liver biopsy increases diagnostic accuracy in acute liver failure. 2014, S. Karger AG, Basel. 240 – 247. DOI:10.1159/000366517
27. HUANG, JY. LU, Q. LIU, JB. Delayed hepatic rupture post ultrasound-guided percutaneous liver biopsy – a case report. Medicine 2018; 97: 1 – 4. DOI:10.1097/MD.0000000000009955
28. PICCININO, F. SAGNELLI, E. PASQUALE, G. GIUSTI, G. Complications following percutaneous liver biopsy. A multicentre retrospective study on 68.276 biopsies. J Hepatol 1986; 2: 165 – 173. DOI:10.1016/s0168-8278(86)80075-7
29. BOSCHUETZ, N. GRAY, M. BARI, K. Portal vein thrombosis after percutaneous liver biopsy. Clinical Gastroenterology and Hepatology 2018; 16: 5 – 6. DOI:10.1016/j.cgh.2017.07.027
30. PENA, LR. HORN, TL. CROSS, CB. Acute pancreatitis secondary to hemobilia after percutaneous liver biopsy. Therap Adv Gastroenterol 2009; 2: 165 – 168. DOI:10.1177/1756283X08103654
31. ZHU, JZ. ZHOU, QY. WANG, YM. DAI, YN. ZHU, J. YU, CH. LI, YM. Prevalence of fatty liver disease and the economy in China: A systematic review. World J Gastroenterol 2015; 21: 5695 – 5706. DOI:10.3748/wjg.v21.i18.5695
32. BRAVO, AA. SHETH, SG. CHOPRA, S. Liver biopsy. N Engl J Med 2001; 344: 495 – 500. DOI:10.1056/NEJM200102153440706
33. SCHEUER, PJ. Liver biopsy size matters in chronic hepatitis: bigger is better. Hepatology 2003; 38: 1356 – 1358. DOI:10.1016/j.hep.2003.10.010
Published
2022-12-14
How to Cite
ALMEIDA, Alexandra M. et al.
VIDEO ASSISTED HEPATIC BIOPSY TECHNIQUE BY MINIMUM INVASIVE DEVICE.
Revista Portuguesa de Cirurgia, [S.l.], n. 53, p. 67-81, dec. 2022.
ISSN 2183-1165.
Available at: <https://revista.spcir.com/index.php/spcir/article/view/843>. Date accessed: 27 july 2024.
doi: https://doi.org/10.34635/rpc.843.
Section
Original Papers
