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The most frequent
complications were vaso-vagal episodes with four collapses that required atropine
treatment. The live threatening complications included hemoperitoneum, biliary
peritonitis, and pneumothorax puncture some due to blind biopsy without ultrasonic
monitoring [33]. The complication rate increased with inceased number of needle passes
that were necessitated by the failure to obtain a material fit for examination (26.6% of
the complications occurred with one manipulation and 68% with two and more manipulations)
[33]. Special concerns on the probability of serious complications arise when more then
two needle manipulations in liver tissue are required [36]. If liver biopsy is performed
under the ultrasonic monitoring, atropine premedication, and if the preliminary
examination is made to eliminate the risk of hemorrhage due to hypocoagulation, the number
of complications related to this procedure decreases drastically. The later study of liver
biopsy in a smaller group group of HCV patients (n=122) reveal no major complications
[19]. Minor complications such as pains that did not require drug intervention were
recorded in 9.5%; the pains that did require drug intervention, in 15.1% and emergency
treatment, in 3.2% of cases. The lack of serious complications in this study may have been
related to the fact all biopsies were carried out in one center in compliance with
standard rules, but also, to the fact that the group of patients was relatively small. |