Background and Aims Mini-laparoscopic liver biopsy (LLB) is a safe procedure with a low rate of bleeding
complications, primarily found in patients with abnormal coagulation parameters (CP)
(Frenzel et al. 2012). But current studies question the validity of classical CP such
as INR/Quick value with regard to a periprocedural bleeding risk in patients with
liver disease.
Methods Retrospective analysis of patients who underwent LLB for unclear hepatopathy (UH)
and/or suspected liver cirrhosis (LC). Relevant bleeding (RB) was defined as the use
of argon plasma coagula-tion (APC) during LLB. Complication (C) was defined as: liver/abdominal
wall hematoma (LHE/AWHE, abdominal bleeding (AB) with the need for surgical intervention.
Results In 376 patients analysed (58% female, median age: 54years), 29% had liver cirrhosis
(LC). RB (n=165) was found significantly more often in LC patients (LC vs. non-LC:
79% vs. 29%; Odds Ratio (OR): 9.1, 95% confidence interval (95%CI): 5.3–15.4; p=.0001).
Complications (n=6 (1.6%): LHE n=4, AB n=2) were more common in LC patients (4.5%
vs. 0.4%; OR: 10.7, 95% CI: 1.44- 126.7; p=.015). Multivariate analysis including
Quick/INR, fibrinogen, aPPT, platelets, patients age, size of the biopsy needle, spleen
size (cm) and presence of LC, aPTT and LC were significantly associated with RB (aPTT:
OR: 1.1, 95% CI: 1.06- 1.19; p=.000; LZ: OR: 6.5, 95%CI: 3.17- 13.5).
Conclusion Severe bleeding complications are rare during LLB. Relevant bleeding occurs especially
in LC patients and can be treated with APC. However, with the exception of aPTT, no
routine coagulation parameters were associated with bleeding risk.
