Edden Yair, St Hilaire Hugo, Benkov Keith, Harris Michael-T
Department of Surgery, Mount Sinai School of Medicine, New York, NY, USA.
World J Gastroenterol. 2006 Jul 21;12(27):4435-6. doi: 10.3748/wjg.v12.i27.4435.
Liver biopsy is generally considered a safe and highly useful procedure. It is frequently performed in an outpatient setting for diagnosis and follow-up in numerous liver disorders. Since its introduction at the end of the 19th century, broad experience, new imaging techniques and special needles have significantly reduced the rate of complications associated with liver biopsy. Known complications of percutaneous biopsy of the liver include hemoperitoneum, subcapsular hematoma, hypotension, pneumothorax and sepsis. Other intra-abdominal complications are less common. Hemobilia due to arterio-biliary duct fistula has been described, which has only rarely been clinically expressed as cholecystitis or pancreatitis. We report a case of a fifteen year-old boy who developed severe acute cholecystitis twelve days after a percutaneous liver biopsy performed in an outpatient setting. The etiology was clearly demonstrated to be hemobilia-associated, and the clinical course required the performance of a laparoscopic cholecystectomy. The post operative course was uneventful and the patient was discharged home. Percutaneous liver biopsy is a safe and commonly performed procedure. However, severe complications can occasionally occur. Both medical and surgical options should be evaluated while dealing with these rare incidents.
肝活检通常被认为是一种安全且非常有用的检查方法。它常在门诊进行，用于多种肝脏疾病的诊断和随访。自19世纪末引入以来，丰富的经验、新的成像技术和特殊的穿刺针已显著降低了与肝活检相关的并发症发生率。已知经皮肝穿刺活检的并发症包括腹腔积血、肝包膜下血肿、低血压、气胸和脓毒症。其他腹部并发症则较少见。因肝动脉-胆管瘘导致的胆道出血已有报道，临床上仅很少表现为胆囊炎或胰腺炎。我们报告一例15岁男孩，在门诊进行经皮肝活检12天后发生严重急性胆囊炎。病因明确为与胆道出血相关，临床病程需要进行腹腔镜胆囊切除术。术后过程顺利，患者出院回家。经皮肝活检是一种安全且常用的检查方法。然而，严重并发症偶尔也会发生。在处理这些罕见事件时，应评估医疗和手术两种选择。
