Ultrasound-guided fine-needle liver biopsy:a multicentre survey of pre-procedure evaluation practice

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A survey report was conducted among 12 Italian centres experi-enced in fine-needle biopsy of the liver.The questions concerned:1.the per-formance of inpatient or outpatient fine-needle biopsy;2.the policy of routinehemostatic evaluation;3.the management of patients taking aspirin;4.thenumber of biopsies performed and the diagnoses obtained;5.the complicationsthat occurred in relation to coagulation tests values.The results were as follows:1.10 out of 12 centres performed biopsiesmainly on outpatients;2.in only 2 of the 12 centres was a history investigatingthe patient’s hemostasis collected;all centres routinely performed coagulationtests;the most frequent combination included prothrombin time,partialthromboplastin time and platelet count.Among the centres a great variabilityconcerning the test values considered safe existed;3.in 10 of the 12 centresbiopsy was not deferred if the patient was taking aspirin;4.the amount ofbiopsies performed was 9156 on a total of 6261 patients,mainly in diagnosingmalignant focal liver lesions;5.in 2 out of 6261 patients(0.03%)bleedingcomplications were fatal and in 8 out of 6261(0.13%)non-fatal but significant.Besides hemostatic decompensation,factors involved in the risk of post-biopsybleeding were the type of the lesion(malignant or hemangiomatous)and the co-existence of cirrhosis. A survey report was carried among 12 Italian centers experi-enced in fine-needle biopsy of the liver. Questions concerned: 1. the per-formance of inpatient or outpatient fine-needle biopsy; 2. the policy of routine hemostatic evaluation; the management of patients taking aspirin; 4. athenic of biopsies performed and the diagnoses obtained; 5. the complication occurred before in relation to coagulation tests values. the results were as follows: 1.10 out of 12 centers performed biopsiesmainly on outpatients; 2 of the 12 centers was a history investigating the patient’s hemostasis collected; all centers routinely performed coagulationtests; the most frequent combination included prothrombin time, partialthromboplastin time and platelet count. Among the centers great variabilityconcerning the test values ​​considered safe exists; 3.in 10 of the 12 centers biopsy was not deferred if the patient was aspirin; 4. the amount ofbiopsies performed was 9156 on a total of 6261 patients, mainly in diagnosed malignant focal liver lesions; 5.in 2 out of 6261 patients (0.03%) bleedingcomplications were fatal and in 8 out of 6261 (0.13%) non-fatal but significant.Besides hemostatic decompensation, factors involved in the risk of post-biopsybleeding were the type of the lesion (malignant or hemangiomatous) and the co-existence of cirrhosis.
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