Complications of percutaneous abdominal fine-needle biopsy. Review

To determine whether the increasing use of percutaneous fine-needle biopsy of abdominal lesions is associated with an increase in serious complications, the author updated a literature search and evaluated a questionnaire (distributed among selected hospitals in the United States in 1986 and 1987) that followed up a questionnaire distributed in 1983. The updated literature review revealed a total of 24 deaths and 20 needle tract seedings. The updated questionnaire revealed five deaths after 16,381 biopsies (0.031%), whereas the previous questionnaire had shown four deaths after 63,108 biopsies (0.006%). Two similar European questionnaires revealed mortality rates of 0.008% and 0.018%, respectively. Of the total of 33 deaths, 21 involved biopsies of liver lesions; six involved pancreatic biopsies. Seventeen of the 21 deaths after liver biopsies were secondary to hemorrhage; five of the six deaths after pancreatic biopsies were due to pancreatitis. Of the 23 instances of needle tract seeding, 10 occurred after biopsies of pancreatic malignancies. The frequencies of needle tract seeding in the four questionnaires were 0.005%, 0.006%, 0.003%, and 0.009%, respectively. Although infrequent, serious complications may be associated with this procedure. The author makes suggestions that may help minimize them.