Mehmet ONAY, Çetin Murat ALTAY, Ali Burak BİNBOĞA

Ultrason Kılavuzluğunda Karaciğer Biyopsisi: Tek Merkez Deneyimleri

Amaç: Bu çalışmanın amacı, kronik hepatitli hastalarda karaciğer fibrozisini derecelendirmek için ultrason eşliğinde tru-cut karaciğer biyopsisinin (US-TKB) güvenliğini ve etkinliğini araştırmaktı. Gereç ve Yöntem: Haziran 2016-Haziran 2021 tarihleri arasında US-TKB yapılan hastalar geriye dönük olarak incelendi. Hastaların demografik özellikleri, biyopsi endikasyonu, komplikasyon oranları not edildi. Biyopsinin etkinliği doku örneğinin yeterliliğine göre belirlendi. Yeniden biyopsi, yetersiz biyopsi olarak kabul edildi. Masif kanama, pnömotoraks ve ölüm majör komplikasyonlar olarak belirlendi. Diğer komplikasyonlar minör komplikasyon olarak not edildi. Morbidite ve mortalite oranları, komplikasyon oranları ve biyopsi endikasyonları arasındaki ilişki araştırıldı. Bulgular: Toplam 1143 hastada 1195 karaciğer parankim biyopsisi yapıldı. Majör komplikasyon oranı %0,16 (n=2), minör komplikasyon oranı %6,1 (n=73) idi. Majör komplikasyonlar masif abdominal kanama %0,08 (n=1) ve pnömotoraks %0,08 (n=1) idi. Minör komplikasyonlar sırası ile %3,2 (n=39) oranında biyopsi sahasında medikasyon gerektiren ağrı, %2,1 (n=26) oranında transfüzyon gerektirmeyen kendini sınırlayan subkapsüler hematom ve %0,6 (n=8) oranında senkop idi. US-TKB efektivitesi %95,5 idi. Mortalite yoktu. Sonuç: Kronik hepatitli hastaların karaciğer fibrozisini derecelendirmek için yapılan US-TKB’de yüksek başarı oranları ile yeterli patolojik spesmen elde edilebilmektedir. US-TKB kronik hepatitli hastalarda güvenli ve etkin bir yöntemdir.

Ultrasound-Guided Liver Biopsy: Single Center Experiences

Objectives: The aim of this study was to investigate the safety and efficiency of ultrasound-guided tru-cut liver biopsy (US-TLB) for grading liver fibrosis in patients with chronic hepatitis. Materials and Methods: Between June 2016 and June 2021, patients who underwent US-TLB were reviewed retrospectively. Patients’ demographics, biopsy indication, and complication rates were noted. The efficiency of the biopsy was determined according to the adequacy of the tissue sample. Re-biopsy was considered as inefficient biopsy. Massive bleeding, pneumothorax and death were determined as major complications. Other complications were noted as minor complications. The relationship between morbidity and mortality rates, complication rates and biopsy indications were investigated. Results: A total of 1195 liver parenchymal biopsies were performed in 1143 patients. Major complication rate was 0.16% (n=2) and minor complication rate was 6.1% (n=73). Major complications were massive abdominal bleeding at the rate of 0.08% (n=1) and pneumothorax at the rate of 0.08% (n=1). Minor complications were pain at the biopsy site requiring medication in 3.2% (n=39), self-limiting subcapsular hematoma not requiring transfusion in 2.1% (n=26), and syncope in 0.6% (n=8), respectively. US-TLB effectiveness was 95.5%. There was no mortality. Conclusion: To grade the liver fibrosis of patients with chronic hepatitis, adequate pathological specimens can be obtained with high success rates in US-TLB. US-TLB is a safe and effective method in patients with chronic hepatitis.

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