The Importance of Experience in Percutaneous Liver Biopsies Guided with Ultrasonography: A Lesion-focused Approach

Rationale and Objectives: The goal of this study is to emphasize the value of lesion-focused approach in ultrasonography (US)-guided solid liver lesion biopsies performed under our guidance. Materials and Methods: In our retrospective study, after the standard preparation for US-guidance solid liver lesion biopsy was accomplished, we performed standard intercostal approach and the biopsy procedure though one of our patients experienced a major complication (pneumothorax). After this undesirable case, we reviewed our biopsy procedure and performed a lesion-focused approach technique as described in this article. A Tru-cut biopsy gun (18 gauge) was used in this trial. The liver biopsies were divided into two groups according to the biopsy technique and all results were compared with each other. Results: A total of 202 solid liver lesion biopsies were was performed under the guidance of US between October 2007 and July 2010. One major complication occurred in first group. All of the minor complications occurred in the first group. In group 2, there were no complications. For this reason, all patients in group 2 were discharged home after a few hours. Patients with minor complications in the first group were observed an average of 6 hours. Adequate tissue for pathological diagnosis was similar in both groups. Conclusion: The lesion-focused approach technique has the potential to reduce both complication rates and patient incompliance. Percutaneous liver biopsies performed with this technique using real-time US guidance are convincing and clinically beneficial.