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Liver biopsy: “blind” or under ultrasound control
  1. I M MURRAY-LYON
  1. Chelsea and Westminster Hospital
  2. 369 Fulham Road, London SW10 9NH, UK
  3. 199 The Strand, London WC2R 1DR, UK
  1. R de WILDE, QC
  1. Chelsea and Westminster Hospital
  2. 369 Fulham Road, London SW10 9NH, UK
  3. 199 The Strand, London WC2R 1DR, UK

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Editor,—We wish to comment on the paper by Shahet al (

) and subsequent correspondence (

) from Aspinall.

The case for the superior safety of ultrasound guided liver biopsy has not yet been proved and the British Society of Gastroenterology Guidelines (1999) do not advocate this as routine best practice. Perforation of the gall bladder is a very rare complication (eight times in 68 276 biopsies in the series reported by Piccinino and colleagues1) and one of us has seen the records of a case in which the gall bladder was punctured at liver biopsy done under real time ultrasound guidance. No technique is entirely safe. Until such time as the evidence clearly supports a change in standard …

R Playford. r.playford{at}ic.ac.uk

R Playford. r.playford{at}ic.ac.uk

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