SAFETY OF PERCUTANEOUS BIOPSY OF HEPATOCELLULAR-CARCINOMA WITH AN 18-GAUGE AUTOMATED NEEDLE

Objective: Accurate histological diagnosis and subtyping of hepatocell ular carcinoma (hepatoma) is likely to be enhanced if a large biopsy t issue specimen is made available to the pathologist, However biopsy of this tumour can be dangerous, especially if the liver is cirrhotic an d the lesion is superficial, This study evaluates the safety of an 18 gauge spring loaded side-cutting needle in the percutaneous biopsy of hepatoma in cirrhotic patients under ultrasonographic (US) guidance. P articular attention was paid to establishing the necessary length of n eedle track through interposing liver parenchyma to be certain of maxi mum safety. Materials and Methods: One hundred and thirty-nine consecu tive biopsy procedures were performed on 129 hepatomas which belonged to 113 men and 12 women of average age 57 +/- 15 years old (median 60, range 8 months-88 years), Ninety-six (69.1%) of these biopsies were p erformed in cirrhotic livers, The length of biopsy needle track traver sing interposing liver parenchyma was less than 1 cm in two cases, 1 c m in 41 cases, between 1 and 2 cm in 46 cases and > 2 cm in 50 cases. The mean tumour size was 7.2 +/- 4.5 cm (median 6.8 cm, range 0.7-25 c m), The average number of needle pass in each biopsy was 2.1 +/- 0.8 t imes (median 2, range 1-5). Results: One hundred and twenty-six (90.6% ) of the biopsy procedures were diagnostic of hepatoma, There were two cases of post-biopsy bleeding, both occurred in procedures with an in terposing liver parenchymal track less than 1 cm in length. Conclusion : The biopsy technique described was found to be safe for diagnosing h epatoma in patients with or without liver cirrhosis provided that the length of interposing liver parenchymal track is not < 1 cm.