A prospective, randomized, two-arm, single-center study to compare efficacy and safety of percutaneous ultrasound-guided liver biopsy of conventional method (multiple liver punctures) versus coaxial method followed by needle tract plugging.
Adult patients who are referred for the ultrasound-guided percutaneous biopsy of focal liver lesion (larger than 1cm) to obtain three or more tissue cores are eligible for this study. Exclusion criteria are as follows: 1) unable to approach a target lesion under ultrasound-guidance; 2) severe coagulopathy; 3) unable to discontinue anticoagulant/antiplatelet medications for the duration proposed by 2019 Society of Interventional Radiology guidelines; 4) co-presence of amyloidosis, large amount of ascites, or acute hepatobiliary infections. All enrolled patients will be randomized into either the conventional group or coaxial/plugging group. The conventional group will undergo percutaneous liver biopsy for multiple tissue cores through multiple punctures of the liver capsule. The coaxial/plugging group will undergo percutaneous liver biopsy using a coaxial needle (single puncture of the liver capsule), which will be plugged by gelatin particles after obtaining multiple tissue cores. The biopsy will be performed on outpatient basis regardless of the randomized group, and the patients will be discharged after two hours of observation. The rate of biopsy-related complications including bleeding (minor and major) and diagnostic yield will be compared between the two groups.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
122
The conventional method utilizes a 18G biopsy gun to acquire three or more tissue cores with the corresponding number of liver capsule punctures. Plugging of the biopsy needle track is not performed.
The coaxial method utilizes a 17G coaxial needle with 18G biopsy gun to acquire three or more tissue cores with a single liver capsule puncture. Biopsy needle track is plugged using a slurry of gelatin particles (EGgel S Plus 2000-4000 μm).
Yonsei University Health System, Severance Hospital
Seoul, South Korea
RECRUITINGSafety of percutaneous liver biopsy
Biopsy-related bleeding * Minor bleeding is defined as presence of linear flow signal along the needle tract on Doppler exam. * Major bleeding is defined as bleeding which requires transfusion or vascular embolization.
Time frame: During procedure
Safety of percutaneous liver biopsy
Biopsy-related bleeding * Minor bleeding is defined as presence of linear flow signal along the needle tract on Doppler exam. * Major bleeding is defined as bleeding which requires transfusion or vascular embolization.
Time frame: Day 1 after procedure
Safety of percutaneous liver biopsy
Biopsy-related bleeding * Minor bleeding is defined as presence of linear flow signal along the needle tract on Doppler exam. * Major bleeding is defined as bleeding which requires transfusion or vascular embolization.
Time frame: Day 7 after procedure
Efficacy of percutaneous liver biopsy
Number of successfully acquired tissue cores; Diagnostic yield
Time frame: 1 week
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