Complications of Liver Biopsy

The liver is the second largest organ in the body after the skin and has important storage, detoxification and synthetic functions. Liver diseases encompass a multitude of pathologies and the management of these diseases involves diagnostic and therapeutic investigations and interventions; some of which are invasive. Histological assessment of the liver and lesions within via liver biopsies are an important tool in the armamentarium of invasive investigations for liver diseases of both a surgical and non-surgical nature. Liver biopsy has been used for over 100 years in the assessment of liver diseases (Valori and Elias 1989). Paul Ehrlich performed one of the first percutaneous liver biopsies in the late 19th century in Germany to assess glycogen levels in the liver of a diabetic patient (Grant and Neuberger 1999). However, the procedure did not really gain popularity until Menghini refined the technique in the mid 20th century(Menghini 1958). In the last fifty years the techniques for liver biopsy has been continuously refined and although today there are several biochemical and imaging techniques to assess liver disease biopsy remains important in assessment. Today, widespread application allows for blind, open and image guided liver biopsies, although ultrasound guided biopsies are considered superior (Younossi, Teran, Ganiats and Carey 1998). Image guided percutaneous liver biopsies remains the mainstay of this procedure while open biopsies may be undertaken as an adjunct to laparoscopic or other open surgical procedures. There are presently various techniques and equipment for percutaneous liver biopsies and this procedure is performed by both gastroenterologists/hepatologists and radiologists. The choice of technique and equipment is however operator dependent.