IMAGE-GUIDED PERCUTANEOUS HEPATIC BIOPSY - EFFECT OF ASCITES ON THE COMPLICATION RATE

PURPOSE: To determine if image-guided percutaneous hepatic biopsy is c ontraindicated in patients with ascites. MATERIALS AND METHODS: The re cords of 476 patients (173 with ascites and 303 without) who underwent image-guided hepatic biopsy were reviewed retrospectively for number of passes, type of needle, and indications. Coagulopathy was corrected with appropriate blood products before biopsy. Complications were cla ssified as minor (decrease in hematocrit value not necessitating treat ment) or major (bleeding that necessitated transfusion or surgery or r esulted in death). RESULTS: Major complications occurred in six patien ts with ascites and 10 without. Minor complications occurred in 10 pat ients with ascites and 15 without. With ascites, all major complicatio ns necessitated blood transfusions but not surgery. Five patients with major complications had a documented moderate or severe amount of per ihepatic ascites. Without ascites, nine of the 10 patients required bl ood transfusions and one required surgery. No deaths occurred in eithe r group. CONCLUSION: Perihepatic ascites does not statistically signif icantly affect the major or minor complication rate of image-guided pe rcutaneous hepatic biopsy.