DIAGNOSTIC PERFORMANCE AND SAFETY OF ULTRASOUND-GUIDED PERCUTANEOUS LIVER BIOPSY

Introduction: The role of liver biopsy in the management of patients with liver disease has changed significantly. The indications for liver biopsy (LB) have changed in recent years due to the development of sensitive and specific non-invasive tests; however, liver biopsy is still sometimes unavoidable. The objective of our study is to analyze the indications for LB and evaluate its sensitivity and yield in the diagnosis of liver diseases.

Materials and methods: This is a retrospective, descriptive study of patients who underwent ultrasound-guided PBH in the hepatology and gastroenterology department over a period of five years (from January 1, 2019, to January 1, 2024). Patient data was collected and analyzed using a data sheet (patients with incomplete files were excluded). Several parameters were analyzed, including age, sex, indications, biopsy fragment size, number of cores, complications, and comparison of pre-biopsy diagnoses with histological reports.

Results:- We collected 233 cases. The average age of our patients was 52.6 years (range: 17-90 years), with the majority being women (52.7%, n=123). An average of 46.6 LB procedures are performed per year. Our patients indications were diverse, with tumor pathology being the most common: secondary liver cancer 34.76% (n=81), nonspecific liver mass 15.4% (n=36), and viral hepatitis, which has become less and less common over the years: hepatitis B 3,86% (n=9), hepatitis C 1.29% (n=3). The objective anatomopathological results were conclusive in 74.24% (n=173) of cases, allowing a definitive diagnosis to be made, and inconclusive in 25.75% (n=60). 6.87% of the latter underwent a second PBH, the results of which were conclusive in 68% (n=11) of cases. The ultrasound-guided PBH procedure was performed without incident in 89.70% (n=209) of cases, with post-procedure pain relieved by analgesics in 9.87% (n=23) and a single case of hemorrhage.

Conclusion: Despite its invasive nature, PBH remains essential in the diagnosis and assessment of liver damage. When performed with strict adherence to contraindications and good ultrasound guidance, it is a safe procedure. Severe complications are rare. Obtaining an efficient yield requires the collection of a significant sample and a detailed pathological report allowing the clinician to analyze and critique the results.