Al-Leswas Dhya, O'Reilly Derek A, Poston Graeme J
Department of Surgery, University Hospital Aintree, Lower Lane, Liverpool, L9 7AL, UK.
Hepatobiliary Pancreat Dis Int. 2008 Jun;7(3):325-7.
Percutaneous radiologically-guided liver biopsy is used routinely worldwide in all secondary-level hospital centers. While it has an undoubted role in the investigation and management of acute and chronic inflammatory conditions of the liver, its role in hepatic oncology is doubtful and probably dangerous.
We report on two patients who underwent preoperative biopsy of potentially resectable liver tumors.
At the time of surgery, there was evidence of seeding at the biopsy site in both cases. In case 1, potentially curative liver resection was rendered incurable because of gross peritoneal carcinomatosis lying adjacent to the site of liver biopsy. In case 2, the patient underwent curative liver resection, but there was histopathological evidence of peritoneal disease beyond the liver capsule along the falciform ligament at the site of the previous biopsy.
No patient with a suspicious liver tumor which is thought to be malignant and has any possibility of being a potential candidate for liver surgery, should be subjected to pre-operative diagnostic biopsy in a non-specialist center.
经皮放射引导下肝活检在全球所有二级医院中心都有常规应用。虽然它在肝脏急慢性炎症性疾病的诊断和治疗中具有毋庸置疑的作用,但其在肝脏肿瘤学中的作用值得怀疑且可能存在危险。
我们报告了两名接受潜在可切除肝脏肿瘤术前活检的患者。
手术时,两例均有活检部位种植的证据。病例1中,由于紧邻肝活检部位存在广泛的腹膜癌转移,原本可能治愈的肝切除术无法实施。病例2中,患者接受了根治性肝切除术,但在先前活检部位沿镰状韧带的肝包膜外有腹膜疾病的组织病理学证据。
对于任何被怀疑为恶性且有可能成为肝脏手术潜在候选者的肝脏肿瘤患者,不应在非专科中心进行术前诊断性活检。