Z Gastroenterol 2019; 57(05): e156
DOI: 10.1055/s-0039-1691918
POSTER
Hepatologie
Georg Thieme Verlag KG Stuttgart · New York

Performance and complications rate of liver biopsies performed by trainees in a newly established Hepatology Department

Authors

  • S Bota

    1   Department of Internal Medicine and Gastroenterology (IMuG), Hepatology, Endocrinology, Rheumatology and Nephrology and Emergency Medicine (ZAE) with Centralized Endoscopy Service, Klinikum Klagenfurt am Wörthersee, Klagenfurt, Austria

  • M Razpotnik

    1   Department of Internal Medicine and Gastroenterology (IMuG), Hepatology, Endocrinology, Rheumatology and Nephrology and Emergency Medicine (ZAE) with Centralized Endoscopy Service, Klinikum Klagenfurt am Wörthersee, Klagenfurt, Austria

  • F Hucke

    1   Department of Internal Medicine and Gastroenterology (IMuG), Hepatology, Endocrinology, Rheumatology and Nephrology and Emergency Medicine (ZAE) with Centralized Endoscopy Service, Klinikum Klagenfurt am Wörthersee, Klagenfurt, Austria

  • K Flatscher

    1   Department of Internal Medicine and Gastroenterology (IMuG), Hepatology, Endocrinology, Rheumatology and Nephrology and Emergency Medicine (ZAE) with Centralized Endoscopy Service, Klinikum Klagenfurt am Wörthersee, Klagenfurt, Austria

  • C Urak

    1   Department of Internal Medicine and Gastroenterology (IMuG), Hepatology, Endocrinology, Rheumatology and Nephrology and Emergency Medicine (ZAE) with Centralized Endoscopy Service, Klinikum Klagenfurt am Wörthersee, Klagenfurt, Austria

  • M Penz-Österreicher

    1   Department of Internal Medicine and Gastroenterology (IMuG), Hepatology, Endocrinology, Rheumatology and Nephrology and Emergency Medicine (ZAE) with Centralized Endoscopy Service, Klinikum Klagenfurt am Wörthersee, Klagenfurt, Austria

  • M Peck-Radosavljevic

    1   Department of Internal Medicine and Gastroenterology (IMuG), Hepatology, Endocrinology, Rheumatology and Nephrology and Emergency Medicine (ZAE) with Centralized Endoscopy Service, Klinikum Klagenfurt am Wörthersee, Klagenfurt, Austria
Further Information

Publication History

Publication Date:
16 May 2019 (online)

Also available at
 

Aim:

to investigate the performance and complications rate of liver biopsies performed by trainees.

Methods:

Our retrospective study included liver biopsies (for diffuse liver disease and liver tumors) performed by trainees between 01/2016 – 02/2019 in our newly established Hepatology-Department in a University affiliated tertiary care teaching hospital.

Biopsies for liver tumors where performed with ultrasound guidance with a Tru-Cut 16G needle (TrueCore II, Argon Medical Devices), while the biopsies for diffuse liver disease where performed with a Menghini 16 G (Braun Hepafix 16G) or TruCut 16G needle.

Results:

142/180 (78.8%) of the liver biopsies performed during the study period where done by 8 trainees and included into the final analysis. The mean age of patients was 62.2 ± 14.2 years (61.2% male).

Biopsies for diffuse liver disease where performed in 58 cases (40.8%), while in 84 cases (59.2%) ultrasound guided biopsies to diagnose liver tumors where done.

Mild pain after biopsies where documented in 19 cases (13.3%), while severe bleeding requiring blood transfusions occurred in 2 cases (1.4%; one liver bleeding and one hemothorax).

Malignant etiology was present in 94% of patients with liver tumors. The main etiologies were: hepatocellular carcinoma (36.7%), cholangiocellular carcinoma (21.5%) and metastasis from pancreatic cancer (18.9%).

Histology was positive in 65/79 (82.2%) cases with malignant liver tumors. In 4 cases with a first negative biopsy, a second biopsy performed by another trainee was positive in 3/4 (75%) cases.

The main 3 indication for diffuse liver biopsy were: autoimmune liver diseases (40.6%), non-alcoholic steatohepatitis (25.4%) and drug induced liver injury (10.1%). Menghini 16G needle was used in 72.5% of cases for diffuse liver disease.

The mean length of liver biopsy specimen was 2.3 ± 0.8 cm, significantly longer for Menghini as compared with TruCut needle: 2.5 ± 0.8 cm vs. 1.7 ± 0.6 cm, p = 0.001.

Conclusion:

We observed a good performance of liver biopsies performed by trainees with a low complications rate.