Small gauge gelfoam plug liver biopsy in high risk patients: safety and diagnostic value

The performance of a percutaneous core biopsy of the liver may be contraindicated in patients at higher risk of haemorrhage. In this clinical setting, gelfoam plug embolization of the needle track has been proposed to minimize haemorrhagic complications of biopsy. In the present study, gelfoam plug liver biopsy was performed in 51 consecutive patients at increased risk of haemorrhage. An 18 gauge spring-loaded disposable cutting needle was used through a 4 French sheath. The biopsy track was embolized by three to four gelfoam pledgets. In every patients, the cores of hepatic tissue were adequate for histopathological diagnosis. There were no fatalities and no serious complications. Gelfoam plug liver biopsy using this needle and sheath in combination appears to be a safe procedure and produces diagnostic cores for histological analysis. This method represents an alternative to transjugular liver biopsy and is technically more straight-forward to perform.