[Gallbladder puncture - a rare percutaneous liver biopsy complication]

Mayor complications of 1000 percutaneous liver biopsies, performed with Menghini's needle for 20 years period (1981-2000) are reported. Five severe complications (0.5%) were observed. Operation was unavoidable in three patients. Four of the major complications were caused by bleeding. Two patients had hematological diseases, and one--chronic kidney failure waiting for kidney transplantation. One patient collapsed immediately after the liver biopsy with bile aspiration. That forced urgent operation in one hour. The possible cause of the complication and the limited theoretical potentialities of ultrasonography and laparoscopy to establish it are discussed. Aspiration of bile during liver biopsy was observed in 0.9% of cases despite the exact keeping of contraindications and technics of examination. Transhepatic puncture of the gallblader is also possible in some of those cases. The necessity to check by ultrasonography the chosen point for biopsy is also emphasized. We recommend to name that biopsy "percutaneous" or "puncture" but not "blind". In this way the second reason (after bleeding) for death after liver biopsy--biliary peritonitis will be reduced to the absolute minimum.