Our Summary

This research paper compares two different types of needles used for liver biopsies: the old standard Tru-cut needle (QC) and a new needle with a reverse bevel design (PC). A liver biopsy involves taking a small sample of liver tissue to examine it for disease or damage.

The researchers looked at 75 patients who had liver biopsies over a seven-year period. For the first four years, all the biopsies were done with the traditional QC needle. For the next three years, the new PC needle was used. The patients in both groups were similar in terms of age, sex, reasons for the biopsy, and liver findings.

The results showed that the new PC needle was more efficient. It required fewer attempts to get a good sample (median 2 vs 3), produced longer samples (median 20 mm vs 9 mm), and had more complete portal tracts (which are the tiny tubes that carry blood to the liver). The samples from the PC needle were also more often adequate for the pathologists to make a diagnosis.

Two patients who had the biopsy with the old QC needle experienced abdominal pain afterwards.

In simple terms, the new PC needle seems to be a better choice for liver biopsies as it requires fewer attempts, gives a better sample for diagnosis, and may cause less post-procedure discomfort.

FAQs

  1. What are the two types of needles compared in this research paper for liver biopsies?
  2. How did the new PC needle perform compared to the traditional QC needle in liver biopsies?
  3. What were the reported side effects of using the old QC needle for liver biopsies?

Doctor’s Tip

The doctor may advise the patient that using a new needle with a reverse bevel design (PC) for a liver biopsy may result in a more efficient and less painful procedure compared to the traditional Tru-cut needle (QC). The new needle may require fewer attempts to get a good sample, produce longer samples, have more complete portal tracts, and increase the likelihood of obtaining a sample adequate for diagnosis. This information may help the patient feel more confident and comfortable about undergoing a liver biopsy.

Suitable For

Patients who are typically recommended for a liver biopsy include those with suspected liver diseases such as hepatitis, cirrhosis, fatty liver disease, liver cancer, autoimmune liver diseases, or unexplained abnormalities in liver function tests. Patients with abnormal imaging findings, unexplained liver enzyme elevations, or suspected liver damage from medications or toxins may also be recommended for a liver biopsy. Additionally, patients who are being evaluated for liver transplant or undergoing treatment for liver diseases may also undergo a liver biopsy to assess the extent of liver damage or monitor treatment response.

Timeline

Timeline of patient experience before and after liver biopsy:

Before:

  1. Patient is informed by their healthcare provider that a liver biopsy is needed to evaluate liver disease or damage.
  2. Patient may undergo blood tests and imaging studies prior to the procedure to assess liver function and determine the need for biopsy.
  3. Patient may be instructed to stop taking certain medications or avoid eating or drinking for a period of time before the biopsy.
  4. Patient is briefed on the procedure, risks, and benefits, and may sign a consent form.
  5. Patient arrives at the hospital or clinic, changes into a hospital gown, and is prepared for the biopsy procedure.

During:

  1. Patient is positioned on their back or side on an examination table.
  2. The skin over the liver is cleaned and numbed with a local anesthetic.
  3. A small incision is made in the skin, and the biopsy needle is inserted through the incision into the liver to collect a tissue sample.
  4. Patient may be asked to hold their breath for a few seconds during the biopsy to reduce movement and minimize the risk of complications.
  5. The needle is removed, and pressure is applied to the biopsy site to stop any bleeding.
  6. The tissue sample is sent to a pathology lab for analysis.

After:

  1. Patient is monitored for a period of time to check for any immediate complications such as bleeding or infection.
  2. Patient may experience some mild pain or discomfort at the biopsy site, which can be managed with over-the-counter pain medications.
  3. Patient is advised to avoid heavy lifting or strenuous activity for a few days following the biopsy.
  4. Patient may be instructed to watch for signs of infection, such as fever, redness, or swelling at the biopsy site.
  5. Patient receives the results of the biopsy from their healthcare provider and discusses any further treatment or follow-up plans.

What to Ask Your Doctor

Some questions a patient should ask their doctor about liver biopsy include:

  1. What type of needle will be used for my liver biopsy?
  2. What are the potential risks and complications associated with the liver biopsy procedure?
  3. How many attempts will be made to obtain a good sample of liver tissue?
  4. How long will the procedure take and will I need to stay in the hospital afterwards?
  5. What can I expect in terms of post-procedure pain and discomfort?
  6. How soon will I receive the results of the liver biopsy?
  7. What specific information will the liver biopsy provide about my liver health?
  8. Are there any specific instructions I need to follow before or after the liver biopsy procedure?
  9. How often will I need to undergo liver biopsies in the future, if at all?
  10. Are there any alternative tests or procedures that could provide similar information without the need for a liver biopsy?

Reference

Authors: Sey MS, Al-Haddad M, Imperiale TF, McGreevy K, Lin J, DeWitt JM. Journal: Gastrointest Endosc. 2016 Feb;83(2):347-52. doi: 10.1016/j.gie.2015.08.012. Epub 2015 Aug 13. PMID: 26278654