PERCUTANEOUS BLIND NEEDLE-BIOPSY VERSUS COMBINED LAPAROSCOPIC EXCISIONAL AND GUIDED NEEDLE-BIOPSY IN THE DIAGNOSIS OF LIVER DISORDERS IN PEDIATRIC-PATIENTS
C. Esposito et al., PERCUTANEOUS BLIND NEEDLE-BIOPSY VERSUS COMBINED LAPAROSCOPIC EXCISIONAL AND GUIDED NEEDLE-BIOPSY IN THE DIAGNOSIS OF LIVER DISORDERS IN PEDIATRIC-PATIENTS, The Italian Journal of Gastroenterology, 29(2), 1997, pp. 179-181
Aims, The authors retrospectively analyzed the results of their experi
ence with combined laparoscopic excisional and guided needle biopsy in
the determination of chronic liver disease in children. Patients and
methods, Between January 1986 and January 1996, at the Division of Ped
iatric Surgery of the ''Federico II'' University of Naples, eighty pat
ients underwent laparoscopic liver biopsy to evaluate a chronic liver
disease. Patient ages ranged between 50 days and 16 years (mean 5.8 ye
ars). There were 41 girls and 39 boys. Fifteen of these children (18.7
%) were addressed to a surgeon because the previously performed percut
aneous blind needle biopsy was nor sufficiently informative or because
the specimens were too small to allow chemical or biochemical tissue
studies. In these 15 patients, we performed a combination of laparosco
pic guided needle biopsy using a 14-gauge tru-cut needle together with
an excisional biopsy on the right lobe, using two additional 5-mm tro
cars. Results and conclusion, The post-operative course was uneventful
for all the patients. All patients were discharged from hospital afte
r 24 hours. A precise histological diagnosis was made and biochemical
tissue studies were possible after laparoscopic biopsy in all 15 child
ren. In our opinion, a combination of laparoscopic-guided needle biops
y and laparoscopic excisional biopsy is more reliable than simple biop
sy alone for the diagnosis of cirrhosis in children with chronic liver
disease.