OBJECTIVETo compare the complication rates induced by three liver biopsy methods.

METHODSOne thousand five hundred fifty-seven liver biopsies were performed from 1995 to 2006 by the senior author of the present article. The patients were grouped into a non-ultrasound-guided biopsy group (783 cases), a partially ultrasound-guided group (485 cases) and an ultrasound-guided group (289 cases). The observed complications such as death, hemorrhage, pneumothorax, pain, choleperitoneum and vasovagal syncope were compared between these three groups.

RESULTSOnly 1 patient in the non-ultrasound-guided group died. Seven patients (45%), 4 in non-ultrasound-guided group, 2 in partially ultrasound-guided group and 1 in ultrasound-guided group, had hemorrhage complications. The hemorrhage complication rates between partially ultrasound-guided group and ultrasound-guided group had no significant differences and both were lower than those of the non-ultrasound-guided group. Thirty-five patients, 23 in non-ultrasound-guided group and 12 in partially ultrasound-guided group, suffered from pneumothorax; but the rates between the two groups were not significantly different. Forty-eight patients (45%), 28 in non-ultrasound-guided group, 17 in partially ultrasound-guided group and 3 in ultrasound-guided group, had severe pain and the rate in the ultrasound-guided group was significantly lower than those of the other two groups.

CONCLUSIONLiver biopsy performed under ultrasound guidance is the safest and most reliable way to do the procedure. It should be recommended in clinical practices.