Article Text

Download PDFPDF
Liver biopsy under ultrasound control
  1. R J ASPINALL, Digestive Disorders Foundation Fellow
  1. ICRF Molecular Oncology Unit
  2. Imperial College School Of Medicine
  3. Hammersmith Hospital, London W12 0NN, UK

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Editor,—I read the recent occasional viewpoint by Shah et al (OpenUrlCrossRefPubMedWeb of Science) with much interest. The authors describe their regional practice of mandatory real time ultrasound guidance for percutaneous liver biopsy in all cases of suspected diffuse liver disease. However, the published literature does not convincingly support the universal adoption of such a policy.

The only prospective randomised study cited in support of their protocol, by Lindor and colleagues,1 is open to a number of methodological criticisms. In particular, in an unspecified proportion of the patents randomised to ultrasound guidance, the procedure was not actually performed under direct guidance and was instead immediately preceded by a “biopsy room” ultrasound scan. The net result of this may have been to selectively raise the pre-biopsy scanning rates in the “ultrasound” cohort who were already more likely to have been previously scanned than the “blind” patients (76–78% v 67–68% in the respective groups).

In terms of the reduction in post-biopsy complications claimed by Lindor et al, the major impact was a reduction in hospitalisation due to pain. There was no statistically significant difference in the rates of bleeding or hypotension. The reduction in …

View Full Text