RESULTS
A total of 569 biopsies were performed during the study period. Due to a
lack of data in the medical records, 37 cases were excluded. Eight
subjects underwent two biopsies, so the study involved 532 biopsies in
524 patients (55.3% male) with a median age of 49 years (range: 13 to
74), as shown in Table 1.
Regarding laboratory tests, INR value and platelets count were available
in 530 procedures. The median and range (minimal – maximum) were 1.01
(0.84 – 1.55) and 200,000/mm3 (48,000 –
474,000/mm3 Almost 40% had cardiovascular
comorbidities, around 18% had overweight or obesity and 2.1% had
chronic kidney disease. Half of the studied population had no
comorbidities (Table 1).
HCV chronic infection assessment was the major indication for PLB
(47.0%), followed by AIH / cholestasis (12.6%) and MAFLD (12.1%). The
amount of HCV-related procedures has sharply reduced. On the other hand,
the number of MAFLD-related biopsies has progressively raised over the
years, as shown in Figure 1.
The median number of needle passes was 1 (ranging from 1 to 4).
PLB-related pain was reported in 53.6% of the studied population. To
relieve it, dipyrone was administered in 40.2% of patients, tramadol in
3.7%, and both medications in 8.1%. Eight patients (1.6%) that
complained of pain did not require any medication. The female gender was
associated with a higher complaint of pain (p=0.0143). There was no
significant influence of other clinical and laboratory variables in the
occurrence of pain (age, comorbidities, platelets count, INR, and number
of needle passes). AEs occurred in 87/532 biopsies (16.4%); they were
mild in 76 (14.3%) and serious in 11 (2.1%) procedures.
The main mild AEs (n=76) were high blood pressure (32/532 – 6.0%),
headache (3.6%), nausea/vomiting (2.4%), low blood pressure (1.5%),
and hypoglycemia (0.2%), as shown in Table 2. The management was oral
captopril, venous dipyrone, venous metoclopramide, venous crystalloid,
and glucose infusion, respectively. Regarding serious AEs (n=11), 5
patients had perihepatic fluid on US, 4 had subcapsular bleeding, and 2
had right-sided hemothorax (Table 2). Ten patients (1.9%) were admitted
to the hospital due to the following conditions: perihepatic fluid on US
examination (n=4), subcapsular bleeding (n=2), hemothorax (n=2), low
blood pressure with nausea/vomiting (n=1) and intense pain at the biopsy
site (n=1). No one patient required surgical treatment and there were no
deaths, as shown in Table 2. There was no association between the
occurrence of mild or serious AEs and the studied variables (clinical,
laboratory, and procedure-related). Renal function was normal in all the
patients that developed bleeding.