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肝活检:做还是不做——一项单中心研究

Liver Biopsy: To Do or Not to Do - A Single-Center Study.

作者信息

Androutsakos Theodoros, Dimitriadis Konstantinos, Revenas Konstantinos, Vergadis Chrysovalantis, Papadakis Dimitrios-Dorotheos, Sakellariou Stratigoula, Vallilas Christos, Hatzis Gregorios

机构信息

Pathophysiology Department, National and Kapodistrian University of Athens, Medical School, Athens, Greece.

Radiology Department, Laiko University Hospital, Athens, Greece.

出版信息

Dig Dis. 2023;41(6):913-921. doi: 10.1159/000533328. Epub 2023 Aug 23.

Abstract

INTRODUCTION

A variety of liver disorders are associated with characteristic histopathological findings that help in their diagnosis and treatment. However, percutaneous liver biopsy (PLB) is prone to limitations and complications. We evaluated all PLBs done in our hospital in a 13-year period, aiming to assess PLB's utility and complications.

METHODS

All PLBs conducted in an internal medicine department of a tertiary university hospital in Athens, Greece, during a 13-year period were reviewed. Recorded data included demographic characteristics, laboratory results acquired on biopsy day, indication for liver biopsy, and occurrence of side effects. All patients were followed for 1 month post-hospital discharge for possible PLB-related complications.

RESULTS

A total of 261 patients underwent PLB during the study period. The commonest indication of PLB was investigation of liver mass, followed by transaminasemia. PLB assisted in setting a diagnosis in 218 patients and was unhelpful in only 43, in 14 of them due to inadequate or inappropriate biopsy specimen. Complications attributable to PLB were rare, with 10 patients exhibiting pain, either at biopsy site or in the right shoulder, and 3 having bleeding episodes; no deaths were noted.

CONCLUSIONS

Our study shows that PLB is still a powerful diagnostic tool in everyday practice, provided it is used when indicated.

摘要

引言

多种肝脏疾病都伴有有助于诊断和治疗的特征性组织病理学表现。然而,经皮肝穿刺活检(PLB)存在局限性和并发症。我们评估了我院13年间进行的所有经皮肝穿刺活检,旨在评估其效用和并发症。

方法

回顾了希腊雅典一所三级大学医院内科在13年间进行的所有经皮肝穿刺活检。记录的数据包括人口统计学特征、活检当天获得的实验室结果、肝活检的指征以及副作用的发生情况。所有患者出院后随访1个月,以观察可能与经皮肝穿刺活检相关的并发症。

结果

在研究期间,共有261例患者接受了经皮肝穿刺活检。经皮肝穿刺活检最常见的指征是肝脏肿块检查,其次是转氨酶升高。经皮肝穿刺活检有助于218例患者明确诊断,仅43例未起到帮助作用,其中14例是由于活检标本不足或不合适。经皮肝穿刺活检引起的并发症很少见,10例患者在活检部位或右肩部出现疼痛,3例有出血情况;未观察到死亡病例。

结论

我们的研究表明,经皮肝穿刺活检在日常实践中仍然是一种强大的诊断工具,前提是在有指征时使用。

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