Chesta J, Smok G
Centro de Gastroenterología, Hospital Clínico, Universidad de Chile, Santiago.
Rev Med Chil. 1992 Feb;120(2):153-7.
Severe clotting defects represent the main contraindication to percutaneous liver biopsy. A transvenous liver puncture technique has been developed for patients suffering from blood coagulation disorders. This approach was attempted in 17 of 148 consecutive patients (12%) in whom a needle liver biopsy was indicated. Hepatic tissue samplings were successfully obtained in 16 subjects. The mean size of the specimens was 7 mm. The clinical diagnosis or therapy were modified in 7 patients when the histopathology report was available. No complications related to the procedure occurred. Our early experience suggests that transvenous liver biopsy is indicated in one/ninth of cases in whom hepatic tissue sample is required for diagnosis. This technique is safe, and it has a high success rate to provide liver tissue samples.
严重凝血缺陷是经皮肝穿刺活检的主要禁忌证。针对患有凝血障碍的患者，已开发出一种经静脉肝穿刺技术。在148例连续的、需要进行针吸肝活检的患者中，有17例（12%）尝试了这种方法。16例患者成功获取了肝组织样本。样本的平均大小为7毫米。当获得组织病理学报告时，7例患者的临床诊断或治疗方案得到了修改。未发生与该操作相关的并发症。我们的早期经验表明，在需要肝组织样本进行诊断的病例中，九分之一的病例适合进行经静脉肝活检。该技术安全，获取肝组织样本的成功率高。
