Are percutaneous transgastric biopsies using 14-, 16- and 18-G Tru-Cut needles safe? An experimental study in the...

We evaluated perforation, peritonitis and bleeding after 14-, 16-, 18-G Tru-Cut needles were passed through the stomach in an animal model. Insertions were performed on seven anaesthetized rabbits with 18-, 16- and 14-G needles simulating the clinical technique. Diluted contrast medium with methylene blue (60 mL) was administered through a nasogastric tube after the biopsy. Computed tomography (CT) scanning of the upper abdomen was performed 10 min after the insertion for leakage. The abdominal contents were inspected by laparotomy. There was no contrast medium leakage outside the gastrointestinal tract on CT images. Neither methylene blue nor other stomach content leakage was identified by laparotomy, even with manual squeezing. A tiny spot of blood was observed on the serosal surface of the stomach with the 18-G needle passes (five cases), whereas a relatively large haematoma was present with 14-G needle (four cases). Six of the rabbits survived and one died due to an inadvertant aortic injury. The results of the study show that transgastric route with an 18-G cutting needle can be used without fear of peritonitis and bleeding.