Experimental Study of Bleeding Control on Liver Biopsy in Rabbit: N-butyl 2-cyanoacrylate(NBCA) injection and RF electrocauterization.
10.3348/jkrs.1997.36.4.595
- Author:
Seong Jin PARK
1
;
Ju Hyung OH
;
Woo Suk CHOI
;
Yup YOON
;
Young Tae KO
;
Joo Won LIM
;
Eui Jong KIM
Author Information
1. Department of Diagnostic Radiology, Kyung Hee University Hospital.
- Publication Type:Original Article
- Keywords:
Liver, biopsy;
Hepatic arteries, therapeutic blockade;
Arteries, therapeutic blockade;
Animals
- MeSH:
Animals;
Biopsy*;
Biopsy, Fine-Needle;
Hemorrhage*;
Hepatocytes;
Liver*;
Necrosis;
Needles;
Neutrophil Infiltration;
Punctures
- From:Journal of the Korean Radiological Society
1997;36(4):595-599
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To evaluate the hemostatic effect of N-butyl 2-cyanoacrylate(NBCA) injection and RF electrocauterization of the tract after fine needle biopsy of the liver, and the histopathologic changes of the liver. MATERIALS AND METHODS: Three lobes of rabbit liver were selected and separately punctured four times with 21 gauge biopsy needles. According to the hemostatic procedure on fine needle biopsy, three groups (1, 2, 3) were formed : group 1, in which there was no maneuver for bleeding control, was the control group ; group 2, in which NBCA was injected into the puncture tract while slowly removing the needle ; group 3, in which RF electrocauterization of the tract was carried out. After completely removing the needle, each group was evaluated for amount of bleeding and histologic change. RESULTS: The amount of bleeding was 0.407gm+/-0.245 in group 1,0.028gm+/-0.036 in group 2 and 0.035gm+/-0.028 in group 3. As compared with the control group(group 1), injecting NBCA into the biopsy tract(P=0.0002) and RF electrocauterization of the tract(P=0.0003) significantly reduced the amount of bleeding after liver biopsy. The amount of bleeding was not statistically different between group 2 and 3, however (P=0.58). In Group 1, the tract was fully filled with blood. Group 2 showed NBCA embolized in the biopsy tract, adhering to hepatocytes and mixed with blood; small vessels adjacent to the puncture tract were filled with NBCA. Group 3 showed tissue degeneration, including necrosis of hepatocytes, vacuolation and neutrophil infiltration. CONCLUSION: Injection of NBCA and RF electrocauterization of the tract after puncture of the liver for biopsy efficiently controlled bleeding. In particular, the efficiency of NBCA injection was due to its effect of plugging the tract and causing the embolization of adjacent small vessels. With regard to procedural handling, RF electrocauterization of the tract is superior to injection of NBCA.
