Rapid Communication
Copyright ©2007 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 28, 2007; 13(40): 5336-5342
Published online Oct 28, 2007. doi: 10.3748/wjg.v13.i40.5336
Liver biopsy in a district general hospital: Changes over two decades
Wing-Kin Syn, Caroline Bruckner-Holt, Adam Farmer, Sarah Howdle, Jeffrey Bateman
Wing-Kin Syn, Liver and Hepatobiliary Unit, Queen Elizabeth Hospital, Birmingham, B15 2TH, United Kingdom
Caroline Bruckner-Holt, Jeffrey Bateman, Department of Gastroenterology, Princess Royal Hospital, Telford, United Kingdom
Adam Farmer, Department of Gastroenterology, City Hospital, Birmingham, United Kingdom
Sarah Howdle, Department of Radiology, Princess Royal Hospital, Telford, United Kingdom
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Wing-Kin Syn, Liver and Hepatobiliary Unit, Queen Elizabeth Hospital, Birmingham, B15 2TH, United Kingdom. wsyn@doctors.org.uk
Telephone: +44-121-4721311-3414 Fax: +44-121-6272449
Received: June 20, 2007
Revised: August 17, 2007
Accepted: September 12, 2007
Published online: October 28, 2007
Abstract

AIM: To study liver biopsy practice over two decades in a district general hospital in the United Kingdom.

METHODS: We identified all patients who had at least one liver biopsy between 1986 and 2006 from the databases of the radiology and gastroenterology departments. Subjects with incomplete clinical data were excluded from the study.

RESULTS: A total of 103 liver biopsies were performed. Clinical data was available for 88 patients, with 95 biopsies. Between 1986 and 1996, 18 (95%) out of the 19 liver biopsies performed were blind and 6 (33%) were for primary biliary cirrhosis. Between 1996 and 2006, 14 (18%) out of 76 biopsies were blind; and the indications were abnormal liver tests (33%), hepatitis C (12%) and targeted-biopsies (11%). Liver biopsies were unhelpful in 5 (5%) subjects. Pain was the most common complication of liver biopsy (5%). No biopsy-related mortality was reported. There was a trend towards more technical failures and complications with the blind biopsy technique.

CONCLUSION: Liver biopsies performed in small district hospitals are safe and useful for diagnostic and staging purposes. Abnormal liver tests, non-alcoholic fatty liver disease and targeted biopsies are increasingly common indications. Ultrasound-guided liver biopsies are now the preferred method and are associated with fewer complications.

Keywords: Complication; District general; Indication; Liver biopsy; Non-alcoholic fatty liver