321 ULTRASOUND ASSISTED PERCUTANEOUS LIVER BIOPSY

A. Jayaprakash¹, M. Callaway², J. Virjee², R.E. Barry¹. ¹Department of Gastroenterology and ²Radiology, Bristol Royal Infirmary, Bristol, UK

Objective: To identify whether US makes a difference to the site of liver biopsy compared to the traditional blind method.

Methods: Design: Prospective study. Setting: University teaching Hospital. All patients who underwent liver biopsy between Nov 2000 and Aug 2001 had the proposed biopsy site localised by traditional percussion by a trainee or consultant. The actual biopsy site was then determined using US by a single operator (trainee) in the same sitting. Then the biopsy was performed using the most appropriate site, away from potential structures that can be encountered in the biopsy needle path.

Results: All patients preferred to have US guided biopsy when they were offered a choice between blind and US guided biopsy. 56 Liver biopsies were performed. Of these, 50% (28) of the patients needed a change in biopsy site after US examination. The changes in the biopsy site were, change in the angle of the needle in 4 patients, in the same space but more anterior or posterior placement in 9 patients, one or more spaces below in 8 patients and in 7 patients biopsy site moved up by one space. The reasons for the change in site were, proximity to gall bladder (12 patients), lung (6), bile duct (5), kidney (1) and a vessel (1) and the better depth of the biopsy needle (5). There was no difference between consultant and trainee (p=0.77) in the frequency with which the proposed biopsy site was changed after US examination.

Conclusions: US did make a difference in the liver biopsy site in 50% of patients. There is no difference in the blind localisation site by consultant and trainee. Adoption …