Syn Wing-Kin, Bruckner-Holt Caroline, Farmer Adam, Howdle Sarah, Bateman Jeffrey
Liver and Hepatobiliary Unit, Queen Elizabeth Hospital, Birmingham, B15 2TH, United Kingdom.
World J Gastroenterol. 2007 Oct 28;13(40):5336-42. doi: 10.3748/wjg.v13.i40.5336.
To study liver biopsy practice over two decades in a district general hospital in the United Kingdom.
We identified all patients who had at least one liver biopsy between 1986 and 2006 from the databases of the radiology and gastroenterology departments. Subjects with incomplete clinical data were excluded from the study.
A total of 103 liver biopsies were performed. Clinical data was available for 88 patients, with 95 biopsies. Between 1986 and 1996, 18 (95%) out of the 19 liver biopsies performed were blind and 6 (33%) were for primary biliary cirrhosis. Between 1996 and 2006, 14 (18%) out of 76 biopsies were blind; and the indications were abnormal liver tests (33%), hepatitis C (12%) and targeted-biopsies (11%). Liver biopsies were unhelpful in 5 (5%) subjects. Pain was the most common complication of liver biopsy (5%). No biopsy-related mortality was reported. There was a trend towards more technical failures and complications with the blind biopsy technique.
Liver biopsies performed in small district hospitals are safe and useful for diagnostic and staging purposes. Abnormal liver tests, non-alcoholic fatty liver disease and targeted biopsies are increasingly common indications. Ultrasound-guided liver biopsies are now the preferred method and are associated with fewer complications.
研究英国一家地区综合医院二十多年来的肝活检实践情况。
我们从放射科和胃肠病科数据库中识别出1986年至2006年间至少接受过一次肝活检的所有患者。临床资料不完整的受试者被排除在研究之外。
共进行了103次肝活检。88例患者有临床资料，共95次活检。1986年至1996年间，所进行的19次肝活检中有18次（95%）是盲穿，6次（33%）是针对原发性胆汁性肝硬化。1996年至2006年间，76次活检中有14次（18%）是盲穿；适应证包括肝功能异常（33%）、丙型肝炎（12%）和靶向活检（11%）。5例（5%）受试者的肝活检无帮助。疼痛是肝活检最常见的并发症（5%）。未报告与活检相关的死亡病例。盲穿活检技术有技术失败和并发症增多的趋势。
在小型地区医院进行的肝活检对于诊断和分期是安全且有用的。肝功能异常、非酒精性脂肪性肝病和靶向活检是越来越常见的适应证。超声引导下肝活检现在是首选方法，且并发症较少。
